Improving patient safety in the perioperative period: surgical safety checklists
Abstract
Surgical complications are an unfortunate part of both medical and veterinary practice, but many are considered to be preventable if appropriate measures are implemented. In human healthcare, one of these measures has been the introduction of surgical safety checklists (SSCs). With proven origins in aviation, another high risk industry, checklists have been linked with the reduction of peri-operative complications and deaths in human hospitals by significant amounts.
Recognising that the core values of SSCs are equally applicable to veterinary practice, the Animal Health Trust implemented their use in November 2008. Since then, positive outcomes observed include increased unity among the multiple specialist teams working in the theatre environment and improved communicaiton of vital information regarding individual patients and surgical procedures.
As recognised by Tivers (2011), surgical complications are an unfortunate element of both medical and veterinary practice. Up to 50% of complications reported within human health care occur within the peri-operative setting and of those, 50% are considered to be preventable (Gawande et al, 1999; de Vries et al, 2008).
‘Never events’ are serious, largely preventable patient safety incidents that should not occur if available preventative measures are implemented (Kizer and Stegun, 2005). While some of these events are unavoidable, it is widely accepted that others are attributable to human error (Christian et al, 2006; Tivers, 2011). Although this has been acknowledged in the veterinary literature, in particular in reference to retained surgical swabs (Tivers, 2011), there has been less veterinary focus on how such ‘never events’ can be reduced. This is despite the presence of an evidence-based initiative developed by the World Health Organisation (WHO), known as the Safe Surgery Saves Lives campaign (World Health Organisation, 2008). What follows here is a discussion of the WHO Surgical Safety Checklist (SSC) devised as a result of this campaign and observations on its adaptation and subsequent implementation into a veterinary practice.
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