Changes in Safety Attitude and Improvement of Multidisciplinary Teamwork by Implementation of the WHO Surgical Safety Checklist in University Hospital

Abstract

Background: We investigated the changes in consciousness of operating team staffs and the influences on the operating time after the implementation of the surgical safety checklist (SSC) using a questionnaire survey. Materials and Methods: 206 operating team staffs (148 surgeons, 20 anesthesiologists, 38 nurses) replied to the questionnaire survey, and the changes in consciousness were checked before and after the implementation of the SSC. We retrospectively investigated the operating time from medical and anesthesia records at the point 2 months before (pre-implementation (pre-I): n = 656) and 2 months after (post-implementation (post-I): n = 650) the implementation. We compared the scheduled operating time, the actual operating time, and the ratio between the two groups. Results: We received replies from 156 operating team staffs, i.e., the recovery rate was 75.7% (156/206). The operating team staffs were interested in 9 items, which included the self-introduction of members, patient referral, surgical procedure, scheduled operating time, predicted blood loss, important matters in the operation, timing of antibiotics, and important matters in anesthesia, and preparation of required materials and equipment. In the multidisciplinary teamwork, they had increased the consciousness of responsibility and communication. There was no significant difference in the scheduled operating time (post-I: 186.9 ± 131.9; pre-I: 184.8 ± 127.8 minutes) and the actual operating time (post-I: 170.8 ± 148.1 minutes; the pre-I: 174.6 ± 147.3 minutes). However, regarding the ratio of the actual operating time to the scheduled operating time, there was a significant difference (the post-I: 0.90 ± 0.43; the pre-I: 0.95 ± 0.45). Use of the SSC significantly decreased the actual operating time. Conclusion: The outcomes of the implementation of SSC resulted in changes in the safety consciousness of the operating team staffs such as their increased responsibility and communication. The improved multidisciplinary teamwork might make them realize a smooth operating progression to shorten the actual operating time.