Webinar 10:Preparation for Expanding to Full

Implementation

Summary of Last Week’s Call• Importance of creating a checklist demonstration video.

• The Safe Surgery 2015: South Carolina Video Competition. Create a video using your hospital’s checklist and/or a video of a poorly done JC Timeout.

• Hospitals shared their experiences implementing the checklist. In particular:

– Preparing surgical teams for testing the checklist.

– Engaging skeptical colleagues in this process.

– Completing the culture survey in your hospital. Strategies to use when administering the survey in paper form.

How Did the Homework Go?

Homework to Date – Slide 1 of 4• Gather an implementation team consisting of at least one administrator,

anesthesia provider, nurse, and surgeon.

• Designate if your hospital will be participating in the research portion of this project.

• Schedule a time and venue for a meeting to take place in 8-10 weeks.

• Read background materials on the checklist and look at safesurgery2015.org website.

• Create a list using the excel template provided to you of all of the OR staff, physicians, and techs. This template asks for names, titles, and email addresses. If you are part of the research, please send us this spreadsheet.

• Send us a picture of your checklist implementation team.

Homework to Date – Slide 2 of 4• Start/Continue to administer the culture survey.

• Modify the checklist for your hospital and test it using “table top simulation” and with your checklist implementation team in 1 case for 1 day.

• Have the same team use the checklist in every case for one day. Modify as necessary and send us your checklist.

• Work with an additional surgical team to test the checklist in as many surgical cases as you can. Modify the checklist as necessary and send us a copy of your checklist.

• Use the Surgical Safety Checklist Observation Tool (Tool 4) in the cases that are testing the checklist.

Homework to Date – Slide 3 of 4• Members of the implementation team need to complete the web-

based training for the teamwork observation tool (Tool 3).

• Identify departmental meetings to have the implementation team speak at following June 28th.

• Use the OR Personnel list that you created for the administration of the culture survey and assign members of the implementation team to talk to everybody individually over the next couple of weeks.

• Identify possible skeptics and make a point to talk to them before you hold a large meeting, if possible.

• Think about ways to advertize the checklist in your hospital in preparation for the roll-out.

Homework to Date – Slide 4 of 4• Create a demonstration video using your hospital’s version of the

South Carolina Surgical Safety Checklist. (All hospitals should do this).

• Finalize your hospital’s version of the checklist.

• Decide if the checklist will be used in poster or paper form in your ORs. If your hospital will be using posters, look into options to have them made.

Optional Homework:

• If you want to be part of the video competition, create and send your hospital’s checklist demonstration video and/or video of a poorly done Joint Commission Time-Out to our team.

Today’s Topics

• Creating timelines and setting goals for your checklist implementation.

• Prioritizing surgical specialties for the roll-out.

• Displaying the checklist in the OR.

This Week’s Poll

1. How will you advertise the checklist in your hospital?

2. How are you planning on displaying the checklist in your OR?

Basic Planning Principles• Arrange things in order of anticipated difficulty. Start with the

surgeon or service that you think will be the most accepting.• Use your OR Personnel Spreadsheet and rank the services.• Create a timeline.• Be flexible. • Give enough time to do the work. It always takes longer than

people initially think.• Assign a member of the checklist implementation team to the

area that will be using the checklist. They will be available to talk to surgical teams and trouble shoot any problems.

Small Hospitals< 4 ORs

• One room/surgeon each day.

• Talk to everybody on the surgical team before they use the checklist for the first time.

Example Timeline for Small Hospital

Date Service Implementation Team Member

Assigned to talk to them

Surgeon Members of the Surgical

Team

Anticipated Difficulty

Monday, July 11th

General Sue Dr. Smith Rita, Mandy, and Dr. Jones.

Easy

Tuesday, July 12th

General Sue Dr. Berry Joanne, Rick, and Dr. Foster

Easy

Wednesday, July

13th

General Katie Dr. Jones Rita, Mandy, and Dr. Jones

Moderate

Thursday, July 14th,

Ortho Dr. Strauss Dr. Smink Joanne, Rick, and Dr. Foster

Difficult

Medium to Large Hospitals

• ~ one service per week.

• Talk to every member of the surgical team prior to when they use the checklist for the first time.

Service Line Roll-out Timeline

Week Service Difficulty

Week 1 General Surgery Easy

Week 2 Plastic Surgery Easy

Week 3 Transplant Surgery Easy

Week 4 Trauma Surgery Moderate

Week 5 Urology Moderate

Week 6 ENT Difficult

Week 7 Cardio-Thoracic Surgery Difficult

Example of a given Week

Date Service Implementation Team Member

Assigned to talk to them

Surgeon Members of the Surgical Team

Anticipated Difficulty

Monday, July 11th

General Mary Dr. Moore CN – Joan AndersonScrub – Suzanne White

CRNA – Chris Jones

Easy

Tuesday, July 12th

General Eric Dr. Berry CN – Linda JohnsonScrub – Lisa Jackson

Anesthesiologist – Paul Harris

Easy

WednesdayJuly 13th

General Eric Dr. Jones CN – Rita MooreScrub – Judy Allen

CRNA – Debra Hughes

Moderate

Thursday, July 14th

General Dr. Strauss Dr. Smink CN – Joan AndersonScrub – Ann Fisher

Anesthesiologist – Randall Johnson

Difficult

Collect Feedback

• Appoint a member of the implementation team to be the point of contact for individuals to talk to.

• If you are using a paper checklist have a space to write comments on the back.

• Set-up a short survey and ask people to complete it throughout the entire implementation process.

The System Needs to Accommodate Feedback

• If an individual raises an issues you need a system in place to fix it.– Increases buy-in.– Motivates individuals to use the checklist and

give feedback.

Displaying the Checklist in the OR

Small Scale Testing

• Paper

• Have circulator hold the checklist up in front of clinicians so they can read their parts aloud.

Roll-Out

• Checklist Poster

• Electronic Medical Record

• Paper

This Week’s Homework• Continue/Start to administer the culture survey.

• Continue to talk with your colleagues one-on-one.

• Hold the meeting that you scheduled at the beginning of the call-series with as many surgical personnel that can attend.

Materials for the Large Meeting

• We have created the following for you to use at your large meeting:– Presentation Template– Presentation Template Guide and Tips

• All of these materials will be available on the Safe Surgery 2015 website later today.

Large Meeting

• Share a story to show them why we want them to do this.

• Share the data that shows that the checklist can do good things.

• Show them an example of a team doing the checklist.

• Tell them the plan to introduce it to the OR.

This Week’s Homework• Continue/Start to administer the culture survey.

• Continue to talk with your colleagues one-on-one.

• Hold the meeting that you scheduled at the beginning of the call-series with as many surgical personnel that can attend.

• Start your checklist advertising campaign.

• Prioritize surgical specialties for the roll-out using your knowledge of which surgeons will be most receptive to the checklist.

• Create a timeline for your hospital’s expansion and send it to the Safesurgery 2015 team at safesurgery2015@hsph.harvard.edu.

• If necessary, hold departmental meetings in the service that you are rolling the checklist out in.

Announcements• The date that the videos are due for the video competition

has been moved back to August 15th.

• The winner will be announced on our last call, August 30th.

• Office hours is cancelled this Friday and July 8th.

• Next week there will NOT be a Tuesday webinar.

• We are making presentations specialized for individuals disciplines. These will be available by the end of next week.

• We need your help for the culture survey. Please encourage your colleagues to take the survey.

??Questions

Ask Us a Question By Using the Raise Hand Button

Office Hours:

Cancelled This Week and Next Week

Next Week’s Call:Cancelled

Happy 4th of July!

Resources

Website:www.safesurgery2015.org

Email: safesurgery2015@hsph.harvard.edu