Educational Exhibit Abstract No. 268 - The time is now: a proposed team-centered approach to a patient safety checklist for interventional radiology procedures

Abstract

Learning Objectives 1) Highlight the importance and demonstrate the need for patient safety checklist in IR procedures. 2) Describe the WHO surgical checklist that is recommended to reduce complications associated with surgery. 3) Demonstrate how these concepts can be applied to the field of Interventional Radiology (IR), and introduce the importance of a team approach to improving patient safety. Background Extensive outcomes research in the surgical community has demonstrated a 3-17% risk of major complications and that approximately 50% of all surgical complications are avoidable. There has been little corresponding research for IR. A team at the World Health Organization (WHO) has designed a 19-item checklist to reduce the rate of surgical complications. Implementation of the checklist was associated with a 36% drop in post-operative complications and death. The purpose of this electronic exhibit is to describe a proposed patient safety-oriented, team-centered checklist for use in IR. Clinical Findings/Procedure Details Utilizing WHO criteria, we have adapted the checklist to emphasize a team approach to patient safety, divided into three major categories. 1) Preprocedure briefing : All members of the IR team meet as a team at the beginning of the day, including: nursing staff, technologists, physician assistants, trainees, and attendings. In order for the Pre-Procedure Briefing to have maximum impact, every member must be prepared to discuss all patients. All nursing staff review the pertinent medical and procedural history, and history of prior sedation use. All physicians review patient history and relevant imaging studies. 2) Time-out : The purpose of the time out is to confirm the patient identity, site, and procedure. At this time, all present parties have an opportunity to re-address present specific concerns regarding the procedure. 3) Postprocedure sign-out : During this time period, the team should review the key concerns for post-procedure patient recovery. Conclusion and/or Teaching Points 1). Patient safety is paramount. 2). Utilizing a checklist has been shown to improve surgical outcomes. 3). A three-step approach involving physicians, nurses, and technologistsworking together as a team can be utilized to implement the procedure checklist.