Design of a sign-out process to improve surgical safety

Abstract

A surgical safety checklist consists of three parts; sign-in, time-out, and sign-out. It has been observed that the sign-out process is the least frequently completed part. We redesigned the sign-out process as a web-based application embedded on a desktop and on a tablet. Both web-based platforms were tested along with the current process on a computer. We recorded time, performance, workload, usability, satisfaction and preference measures for these three approaches in operating rooms. The time to complete the sign-out process was the longest using the WebApp on the desktop and the shortest using the current system. The WebApp on both electronic devices resulted in fewer items being skipped than the current system. The web-based app on the desktop resulted in fewer items not being discussed than the current system. Frustration was rated as lower with the WebApp on the desktop than with the current system. The WebApp on the desktop was rated higher than the current system for situation awareness, detecting errors, understanding the benefits of the sign-out process, and ability to view information all at once. The WebApp on both electronic devices was rated higher than the current system for maintaining records and foraccessibility from all locations.