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Use of a safe procedure checklist in the cardiac catheterisation laboratory

BACKGROUND: The use of the WHO safe surgery checklist has been shown to reduce morbidity and mortality from surgical procedures. However, whether a WHO-style safe procedure checklist can improve safety in the cardiac catheterisation laboratory (CCL) has not previously been investigated. OBJECTIVES:...

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Autores principales: Lindsay, Alistair C, Bishop, Jeremy, Harron, Katie, Davies, Simon, Haxby, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059321/
https://www.ncbi.nlm.nih.gov/pubmed/30057949
http://dx.doi.org/10.1136/bmjoq-2017-000074
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author Lindsay, Alistair C
Bishop, Jeremy
Harron, Katie
Davies, Simon
Haxby, Elizabeth
author_facet Lindsay, Alistair C
Bishop, Jeremy
Harron, Katie
Davies, Simon
Haxby, Elizabeth
author_sort Lindsay, Alistair C
collection PubMed
description BACKGROUND: The use of the WHO safe surgery checklist has been shown to reduce morbidity and mortality from surgical procedures. However, whether a WHO-style safe procedure checklist can improve safety in the cardiac catheterisation laboratory (CCL) has not previously been investigated. OBJECTIVES: The authors sought to design and implement a safe procedure checklist suitable for all CCL procedures, and to assess its impact over the course of 1 year. METHODS: In the first 3 months, weekly PDSA cycles (Plan-Do-Study-Act) were used to optimise the design of the checklist through testing and staff feedback, and team briefing sessions were introduced before each procedure list. The impact of the checklist and team briefs was assessed by analysing in-house procedural data subsequently submitted to national audit databases. Staff and patient questionnaires were performed throughout the year. RESULTS: Introduction of the checklist was associated with a significant reduction of 3 min in average turnaround time (95% CI 25 s to 6 min, p=0.027). Similarly, an initial reduction in patient radiation exposure was recorded (dose area product reduction of 641.5 cGy/cm(2); 95% CI 255.9 to 1027.1, p=0.002). The rate of reported complications from all procedures fell significantly from 2.0% in 2012/2013 (95% CI 1.6% to 2.4%) to 0.8% in 2013/2014 (95% CI 0.6% to 1.1%, p≤0.001). Staff climate questionnaires showed that technicians and radiographers gave more positive responses at the end of the study period compared with the beginning (p=0.001). CONCLUSIONS: The use of a team brief and WHO-derived safe procedure checklist in the CCL was associated with decreased radiation exposure, fewer procedural complications, faster turnarounds and improved staff experience.
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spelling pubmed-60593212018-07-27 Use of a safe procedure checklist in the cardiac catheterisation laboratory Lindsay, Alistair C Bishop, Jeremy Harron, Katie Davies, Simon Haxby, Elizabeth BMJ Open Qual BMJ Quality Improvement report BACKGROUND: The use of the WHO safe surgery checklist has been shown to reduce morbidity and mortality from surgical procedures. However, whether a WHO-style safe procedure checklist can improve safety in the cardiac catheterisation laboratory (CCL) has not previously been investigated. OBJECTIVES: The authors sought to design and implement a safe procedure checklist suitable for all CCL procedures, and to assess its impact over the course of 1 year. METHODS: In the first 3 months, weekly PDSA cycles (Plan-Do-Study-Act) were used to optimise the design of the checklist through testing and staff feedback, and team briefing sessions were introduced before each procedure list. The impact of the checklist and team briefs was assessed by analysing in-house procedural data subsequently submitted to national audit databases. Staff and patient questionnaires were performed throughout the year. RESULTS: Introduction of the checklist was associated with a significant reduction of 3 min in average turnaround time (95% CI 25 s to 6 min, p=0.027). Similarly, an initial reduction in patient radiation exposure was recorded (dose area product reduction of 641.5 cGy/cm(2); 95% CI 255.9 to 1027.1, p=0.002). The rate of reported complications from all procedures fell significantly from 2.0% in 2012/2013 (95% CI 1.6% to 2.4%) to 0.8% in 2013/2014 (95% CI 0.6% to 1.1%, p≤0.001). Staff climate questionnaires showed that technicians and radiographers gave more positive responses at the end of the study period compared with the beginning (p=0.001). CONCLUSIONS: The use of a team brief and WHO-derived safe procedure checklist in the CCL was associated with decreased radiation exposure, fewer procedural complications, faster turnarounds and improved staff experience. BMJ Publishing Group 2018-07-13 /pmc/articles/PMC6059321/ /pubmed/30057949 http://dx.doi.org/10.1136/bmjoq-2017-000074 Text en © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle BMJ Quality Improvement report
Lindsay, Alistair C
Bishop, Jeremy
Harron, Katie
Davies, Simon
Haxby, Elizabeth
Use of a safe procedure checklist in the cardiac catheterisation laboratory
title Use of a safe procedure checklist in the cardiac catheterisation laboratory
title_full Use of a safe procedure checklist in the cardiac catheterisation laboratory
title_fullStr Use of a safe procedure checklist in the cardiac catheterisation laboratory
title_full_unstemmed Use of a safe procedure checklist in the cardiac catheterisation laboratory
title_short Use of a safe procedure checklist in the cardiac catheterisation laboratory
title_sort use of a safe procedure checklist in the cardiac catheterisation laboratory
topic BMJ Quality Improvement report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059321/
https://www.ncbi.nlm.nih.gov/pubmed/30057949
http://dx.doi.org/10.1136/bmjoq-2017-000074
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