Making surgical care safer: a survey on the implementation of the checklist by Belgian surgeons

L. Michel – Acta Chirurgica 2015, 115: 334-340.

Abstract

Background: The operating theatre (OT) is a complex environment. The purpose of this survey was to evaluatethe implementation of the surgical checklist (SC) at individual level by Belgian Surgeons.

Methods: A Surgical Checklist Questionnaire (SCQ) related to the use of the SC by individual surgeons was attached tothe registration website for the 2015 Belgian Surgical Week. It was a one page long, user friendly document, easy to befilled voluntarily and anonymously.

Results : Among the 206 surgeons who registered, 81 (39%) filled in the SCQ. The SC template proposed by the WHO“Safe Surgery Saves Lives” initiative was used by 91% of the respondents. However, 89% adapted the SC to their localhospital environment, and 87.5% use it personally for their patients. Since implementation, the SC was never adapted in46%. According to 21% of respondents, an adverse event was avoided thanks to the SC. Amazingly, SC was consideredas an administrative burden by 83% despite the same percentage recognized that patients benefited from the SC. Only28% of respondents got feedback from the use of the SC.

Conclusions: In this survey, the number of adverse event avoided thanks to the use of the SC demonstrates that SCrepresents a simple strategy for addressing surgical patient safety in OT. Nevertheless, SC is still considered by manysurgeons as an additional administrative burden and/or as just another gimmick. Further studies are needed to understandwhy some surgeons are still not willing to adapt to a changing safety culture.