Transcript Poll 4: The Checklist as a Documentation Tool

Call 5:
Checklist Modification 101 Continued,
Small Scale Testing, and the Checklist as
a Documentation Tool
Last Week’s Call
• The importance of modifying the checklist
for your hospital.
• Modification 101.
• Lynn Wythe from Palmetto Baptist shared
her experiences implementing the checklist.
How Did the Homework Go?
Homework to Date
• Build an implementation team.
• Schedule a time and venue for a meeting to take place after
January.
• Send us an email at: [email protected]
letting us know how you would like to administer the survey at
your hospital. Please also include your mailing address in this
email.
• Download the OR Personnel Spreadsheet from our website
and begin completing the information with the names, roles,
and email addresses if relevant.
• Review the checklist modification guide and South Carolina
Checklist Template.
• Start to modify the checklist your implementation team.
Poll 1: Did You Review the
Checklist Modification Guide?
• Yes
• No
Poll 2: Have You Started to
Modify the Checklist For Your
Hospital?
• Yes
• No
Meeting the Team
Jim Sachetta
Staff Assistant
Today’s Topics
• Modification 101 Continued.
• Small-Scale Testing: “Table-Top Simulation”.
• The Checklist as a Documentation Tool.
Checklist Modification 101
Continued
The Next Step in Your Journey:
Make Me Your Own
Alternative Arrangements of
the Checklist
Alternative Wording for
Particular Items
Modifying Blood Loss
 Are blood products required and
available?
What is the EBL?
Blood (or cross-match) available if
needed.
Is there a need for blood
products?
Blood availability confirmed.
EBL/Blood Plan
Modifying Team Introductions
 We will start by introducing ourselves
by name and role.
 Team introductions to patient,
including name and role.
 Are there any unfamiliar staff in the
room? Please introduce yourself by
name and role.
What If We Already Know Each Other?
Modifying the Safety Statement
Surgeon says: “If anyone on the team
sees something that the team should
know about, please speak up”
Surgeon declares: “If anyone on the
team sees something that the team
should know about, please speak up
anytime during the procedure.”
Surgeon states, “If you see, suspect,
or feel that patient care is compromised,
will you speak up?”
Surgeon states, “Remember that all
are free to voice any concerns at any
time throughout the procedure”
Surgeon states, “Does anyone have
concerns? If you think there is a
problem, please speak up”
When You Modify the Checklist
with Your Implementation
Team:
– Discuss each item on the checklist using the
guidelines that we previously discussed.
– Ensure that the checklist follows your current
flow in the OR.
– Add your hospital logo to the checklist.
– Say the words on the checklist aloud. Many
times it looks good on paper and does not
reflect what you would actually say during a
case.
Examples of Modified
Checklists
Small Scale Testing:
“Table-Top Simulation”
Table-Top Simulation
• It is easy to test the checklist outside of
the OR.
• It doesn’t take a lot of time.
• You can learn a ton.
• Testing the checklist on a small scale can
prevent you from making BIG mistakes.
“Table-Top” Simulation
S
Anes.
Machine
CN
A
SN
Conference Room or
an Empty OR
“Table-Top” Simulation
Our Patient
• Age - 68 yr old male
• Condition – Healthy patient with a right
inguinal hernia
• Procedure – Right inguinal hernia repair
The Checklist as a
Document Tool
Poll 3: The Checklist as a
Documentation Tool
• How many of you want to use the checklist
as an auditing tool?
• When you discussed the checklist with
your colleagues, did they have concerns
about including the checklist in the medical
record?
• If you are already using the checklist, do
you keep it as part of the medical record?
Using the Checklist As a
Documentation Tool
• SCIP Measures
• Electronic Medical Record
• Patient Chart
• Signatures
• Malpractice issues
SCIP Measures
• It can be used to document SCIP
Measures.
• Be careful to make certain that your
documentation is consistent.
Electronic Medical Record
• The checklist is compatible with the EMR.
• You want to avoid the checklist becoming
a “tick the box” exercise.
Signatures at the Bottom
• Depends on the culture of your hospital.
• Can be looked at as punitive.
• It is best to have the entire team to sign it
if you are going to use signatures so that
responsibility is shared.
Patient Chart
• Many hospitals do not include it in the
patient record.
• If you are going to put it in the chart to
document make sure that the nurse isn’t
the only one using the checklist.
Malpractice Concerns
We will never know which
patient the checklist helps
because of information that
was shared and problems that
were prevented.
This Week’s Homework
• Continue to modify your hospital’s checklist.
• Test your checklist using “table-top
simulation”.
• Email our team and let us know if you will be
administering the culture survey.
Email: [email protected]
Questions
Ask Us a Question By Using the
Raise Hand Button
Next Call:
Testing the Checklist in the
OR
Office Hours:
Cancelled Tomorrow
Resources
Website:
www.safesurgery2015.org
Email:
[email protected]