Abstract 247: The Use of a World Health Organisation Derived Safe Surgery Checklist to Improve Patient Experience in the Cardiac Catheterisation Laboratory

Abstract

Background: The WHO safe surgery checklist has reduced morbidity and mortality during surgery. Whether or not a modified WHO checklist could improve patient and staff experience in the cardiac catheterisation laboratory (CCL), where the majority of procedures are carried out under local anaesthetic, has not previously been investigated. Methods: Starting in March 2013, a WHO-derived checklist, specifically modified for the CCL, was introduced at the Royal Brompton Hospital. For three months, weekly PDSA cycles and staff feedback were used to optimise checklist design, followed by a full rollout. Patient experience (n=76, taken throughout the six-month period) and staff safety climate (taken 2 and 7 months after checklist introduction) surveys were undertaken to measure subjective impact. Clinical outcomes and efficiency data were obtained from in-house databases. Results: • By six months, a full checklist (Figure 1) was completed in 367/417 (88%) of procedures (Figure 2). Patient surveys revealed that the majority of patients (57%) noticed the staff ‘Time Out’ and when questioned, strongly associated the checklist with safety (mean score 9.3/10 using Likert scale) and found it highly reassuring (mean 8.9/10). • The majority of procedures that used the checklist (56%) were shorter than average, whereas the majority of procedures that did not use a checklist took longer than average (P<0.0001) • When the full checklist was used, screening time was correspondingly reduced in 25% more procedures Conclusions: The introduction of a WHO-derived checklist was associated with high levels of patient satisfaction, improved efficiency, and enhance team cohesion during procedures in the cardiac catheterisation laboratory.