Last Week’s Call

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Call 5: Checklist Modification 101 Continued, Small Scale Testing, and the Checklist as a Documentation Tool

description

Call 5: Checklist Modification 101 Continued, Small Scale Testing, and the Checklist as a Documentation Tool. Last Week’s Call. The importance of modifying the checklist for your hospital. Modification 101. Lynn Wythe from Palmetto Baptist shared her experiences implementing the checklist. - PowerPoint PPT Presentation

Transcript of Last Week’s Call

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Call 5: Checklist Modification 101 Continued,

Small Scale Testing, and the Checklist as a Documentation Tool

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Last Week’s Call• The importance of modifying the checklist

for your hospital.• Modification 101.• Lynn Wythe from Palmetto Baptist shared

her experiences implementing the checklist.

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How Did the Homework Go?

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Homework to Date• Build an implementation team.

• Schedule a time and venue for a meeting to take place after January.

• Send us an email at: [email protected] letting us know how you would like to administer the survey at your hospital. Please also include your mailing address in this email.

• Download the OR Personnel Spreadsheet from our website and begin completing the information with the names, roles, and email addresses if relevant.

• Review the checklist modification guide and South Carolina Checklist Template.

• Start to modify the checklist your implementation team.

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Poll 1: Did You Review the Checklist Modification Guide?• Yes• No

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Poll 2: Have You Started to Modify the Checklist For Your

Hospital?• Yes• No

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Meeting the Team

Jim SachettaStaff Assistant

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Today’s Topics• Modification 101 Continued.• Small-Scale Testing: “Table-Top Simulation”.• The Checklist as a Documentation Tool.

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Checklist Modification 101 Continued

The Next Step in Your Journey:Make Me Your Own

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Alternative Arrangements of the Checklist

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Alternative Wording for Particular Items

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Are blood products required and available?

What is the EBL?

Blood (or cross-match) available if needed.

Is there a need for blood products?

Blood availability confirmed.

EBL/Blood Plan

Modifying Blood Loss

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Modifying Team Introductions We will start by introducing ourselves

by name and role.

Team introductions to patient, including name and role.

Are there any unfamiliar staff in the room? Please introduce yourself by name and role.

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What If We Already Know Each Other?

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Modifying the Safety StatementSurgeon says: “If anyone on the team sees something that the team should know about, please speak up”

Surgeon declares: “If anyone on the team sees something that the team should know about, please speak up anytime during the procedure.”

Surgeon states, “If you see, suspect, or feel that patient care is compromised, will you speak up?”

Surgeon states, “Remember that all are free to voice any concerns at any time throughout the procedure”

Surgeon states, “Does anyone have concerns? If you think there is a problem, please speak up”

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When You Modify the Checklist with Your Implementation

Team: – Discuss each item on the checklist using the

guidelines that we previously discussed.– Ensure that the checklist follows your current

flow in the OR.– Add your hospital logo to the checklist.– Say the words on the checklist aloud. Many

times it looks good on paper and does not reflect what you would actually say during a case.

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Examples of Modified Checklists

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Small Scale Testing:“Table-Top Simulation”

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Table-Top Simulation• It is easy to test the checklist outside of

the OR.• It doesn’t take a lot of time.• You can learn a ton.• Testing the checklist on a small scale can

prevent you from making BIG mistakes.

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“Table-Top” Simulation

Anes.Machine

ACN

SN

S

Conference Room or an Empty OR

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“Table-Top” Simulation

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Our Patient• Age - 68 yr old male• Condition – Healthy patient with a right

inguinal hernia • Procedure – Right inguinal hernia repair

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The Checklist as a Document Tool

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Poll 3: The Checklist as a Documentation Tool

• How many of you want to use the checklist as an auditing tool?

• When you discussed the checklist with your colleagues, did they have concerns about including the checklist in the medical record?

• If you are already using the checklist, do you keep it as part of the medical record?

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Using the Checklist As a Documentation Tool

• SCIP Measures

• Electronic Medical Record

• Patient Chart

• Signatures

• Malpractice issues

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SCIP Measures• It can be used to document SCIP

Measures.• Be careful to make certain that your

documentation is consistent.

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Electronic Medical Record• The checklist is compatible with the EMR.• You want to avoid the checklist becoming

a “tick the box” exercise.

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Signatures at the Bottom• Depends on the culture of your hospital.• Can be looked at as punitive.• It is best to have the entire team to sign it

if you are going to use signatures so that responsibility is shared.

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Patient Chart• Many hospitals do not include it in the

patient record.• If you are going to put it in the chart to

document make sure that the nurse isn’t the only one using the checklist.

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Malpractice Concerns

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We will never know which patient the checklist helps because of information that was shared and problems

that were prevented.

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This Week’s Homework• Continue to modify your hospital’s checklist.• Test your checklist using “table-top

simulation”.• Email our team and let us know if you will be

administering the culture survey. Email: [email protected]

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?Questions

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Ask Us a Question By Using the Raise Hand Button

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Next Call:Testing the Checklist in the

OR

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Office Hours: Cancelled Tomorrow

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Resources

Website: www.safesurgery2015.org

Email: [email protected]