This study presents an exploration of the factors which influence the successful implementation of the WHO Surgical Safety Checklist. A mixed methodological approach using a questionnaire was sent to 348 healthcare professionals in a single NHS trust who use the WHO checklist. 103 questionnaires were returned; five were incomplete and discarded. Data was analysed from 98 questionnaires. Results were evaluated alongside recommendations from a previous audit that took place in this trust in 2013. 63% of surgeons and 54% of anaesthetists within the trust remain untrained as regards the surgical safety checklist. Sign out was the poorest performing component; time out also needed improvement. The biggest obstacle in successful implementation was found to be disengagement of the surgical team. Simulation and team training can enhance non-technical skills, improving communication between staff. The study concludes that differing staff perceptions were found to create barriers to successful implementation of the checklist. Training of all staff is necessary for effective communication within the operating theatre.
FlickU.2009An introduction to qualitative researchLos Angeles, SAGE Publications
2.
FlinR., O'ConnorP., CrichtonM.2008Safety at the sharp end: A guide to non-technical skillsAldershot, Ashgate
3.
AdairJ.G.1984The Hawthorne effect: A reconsideration of the methodological artefactJournal of Applied Psychology69(2) 334–45
4.
AwadS., FaganS., BellowsC.2005Bridging the communication gap in the operating room with medical team trainingAmerican Journal of Surgery (190) 770–74
5.
BöhmerA.B., KindermannP., SchwankeU.2013Long-term effects of a perioperative safety checklist from a viewpoint of personnelActa Anaesthesiology Scandinavia (57) 150–57
6.
BraafS., ManiasE., RileyR.2013The time out procedure: An institutional ethnography of how it is conducted in actual clinical practiceBritish Medical Journal Quality and Safety (22) 647–55
7.
CabanaM.D., RandC.D., PoweN.R.1999Why don't physicians follow clinical practice guidelines? A framework for clinical improvementJournal of American Medical Association (282) 1458–65
8.
CalvinC., RobbW.2013Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safetyClinical Orthopaedic Related Research4711792–1800
9.
CarneyB., WestP., NeilyJ.2010Differences in nurse and surgeon perception of teamwork: implications for use of a briefing checklist in the ORAORN Journal91(6) 722–29
10.
CatchpoleK., MishraA., HandaA., McCullochP.2008Teamwork and error in the operating room: analysis of skills and rolesAnnals of Surgery4(247) 699–706
11.
ConleyD.M., SingerS., EdmonsonL.2011Effective surgical safety checklist implementationJournal of American College of Surgeons212873–79
12.
FourcadeA., BlacheJ.L., GrenierC.2011Barriers to staff adoption of a surgical safety checklistBritish Medical Journal Quality and Safety94
13.
HannamJ.A., GlassL., KwonJ.2013A prospective, observational study of the effects of implementation strategy on compliance with a surgical safety checklistBritish Medical Journal Quality and Safety (22) 940–47
14.
KammiS., PohlS., SchonerF.2010Boolean versus ranked querying for biomedical systematic reviewsBMC Medical Informatics and Decision Making (10)
15.
KoutantjiM., McCullocxhP., UndreS.2008Is team training in briefings for surgical teams feasible in simulation?Cognition Technology and Work (10) 275–85
16.
LingardL., RegehrG., OrserB.2008Evaluation of preoperative checklist and team briefing among surgeons, nurses and anaesthesiologists to reduce failures in communicationArchives of Surgery143(1) 12–17
17.
MakaryM.A., SextonJ.B., FreischlagJ.A.2006Operating room teamwork among physicians and nurses: Teamwork in the eye of the beholderJournal of American College of Surgeons (202) 746–52
18.
MakaryM.A., MukherjeeA., SextonJ.B.2007Operating room briefings and wrong-site surgeryJournal of American College of Surgeons (204) 236–43
NgoziS.2013WHO surgical checklist staff survey: Is it worth it?Northampton General Hospital NHS Trust
22.
NugentE., HseinoH., RyanK.2013The surgical safety checklist survey: a national perspective on patient safetyIrish Journal of Medical Science182(2) 171–176
23.
PapaconstantinouH., JoC., ReznikS.2011Implications of a surgical safety checklist: Impact on surgical team perspectivesThe Ochsner Journal (13) 299–309
24.
PickeringS.P., RobertsonE.R., GriffinD.2013Compliance and use of the World Health Organization checklist in UK operating theatresBritish Journal of Surgery1001664–70
25.
SalasE., RosenM., KingH.2007Managing team managing crisis: Principles of teamwork to improve patient safety in the emergency room and beyondJournal of Theoretical Issues in Ergonomics Science8(5) 381–94
26.
ThabaneL., MaJ., ChuR.2010A tutorial on pilot studies: the what, why and howBMC Medical Research Methodology1(10)
27.
WolfF.A., WayL.W., StewartL.2010The efficacy of medical team training: improved team performance and decreased operating room delaysAnnals of Surgery (252) 477–85
28.
World Health Organisation2008Implementation manual surgical safety checklist Available from: www.who.int/patientsafety/en/ [Accessed July 2016]
29.
YeeB., NaikV.N., JooH.S.2005Non-technical skills in anaesthesia crisis management with repeated exposure to simulation-based educationAnesthesiology103241–48
