Surgical Safety Checklists in Operative Medicine in Switzerland

Abstract

Reto Kaderli, Ramona Cecini Hertig, Urban Laffer, Adrian P. Businger

Objective: Despite the known positive impact of surgical checklists on morbidity and mortality rates, data on the implementation of checklists in Swiss operating rooms as well as the resulting experiences are missing. The present study evaluated the general use and design of checklists in operative medicine in Switzerland, the difficulties in introduction and the subjective impact on adverse events. Methods: An anonymous national survey of directors of adult departments in operative medicine in Switzerland was conducted during spring 2011. They were identified from the database of the Swiss college of surgeons (fmCh). The survey included questions about the use, type and content of the used checklists, the prevention of mixing up patients and the awareness of wrong site surgery. Results: Overall, 237/799 (29.7%) surveys were returned. At the time of the survey, 172/233 (73.8%) departments used surgical checklists (4 missing values). The median time needed for collecting data per patient was 60 (range 10-600) seconds. In all, 46/161 (28.6%) participants reported a subjective decrease of adverse events after the introduction of a surgical checklist (11 missing values). Out of 217 respondents, 62 (28.6%) knew of one event and 87 (40.1%) of more than one event of wrong site surgery (20 missing values). Conclusions: There is still room for improvement in the use of surgical checklists, which impresses, in regard to the time needed for data collection per patient, and which is not excessively time-consuming. However, acceptance problems of the majority of respondents during the introduction phase of surgical checklists vanished over time.