Towards better patient safety: WHO Surgical Safety Checklist in otorhinolaryngology

Objectives: The World Health Organisation has developed a Surgical Safety Checklist to improve patient safety during surgery. This checklist has reduced postoperative morbidity and mortality. Prior to checklist implementation, we wanted to evaluate how it would fit into the process of otorhinolaryngology-head and neck surgery and whether it would have an impact on the awareness of safety-related issues. Design: A structured questionnaire was addressed to the operating room team after consecutive operations during a 1-month period before and after checklist implementation. Setting and participants: This study was conducted at the Department of Otorhinolaryngology at the Helsinki University Central Hospital as a part of a multicentre study. Responses were received regarding 288 operations before and 412 after checklist implementation. Main outcome measures: The questions concerned patient-related safety checks, teamwork and communication. Results: The checklist improved verification of the patient's identity (P < 0.001). Awareness of the patient's medical history, medication and allergies increased (P < 0.001). Knowledge of the names and roles among the team members improved. The otolaryngologists and anaesthesiologists discussed possible critical events more often (P < 0.001), and postoperative instructions were better recorded after use of the checklist. In addition, the checklist enhanced communication between operation team members. Conclusions: Our study confirms that the Surgical Safety Checklist fits well into the surgical working process in otorhinolaryngology-head and neck surgery improving the sharing of patient-related medical information between team members. Development of a specific checklist for otolaryngology calls for further study.