Partner with physicians
If you're not at 100% compliance, you need to find out why.
Present the data to your physicians and start the conversation based
on the results of the survey tool. To make real change happen, your
docs must be on board with your efforts to improve checklist usage. A
general surgeon and anesthesiologist championed our cause, and their
efforts were instrumental in getting the surgical team to buy into the
importance of completing the checklist for every patient.
Don't make protocols for completing the checklist so structured
that it becomes a burden for teams to complete or doesn't fit with
how individual surgeons prefer to work. For example, one of our sur-
geons likes to complete the checklist after he's gowned and gloved
and ready to cut. Another physician likes to complete it before the
patient is draped, so he can easily see the intended surgical site. Allow
for those variations, as long as the core elements of the checklist are
covered.
Assign roles
The checklist prompts a conversation among the surgical team
members, who should each know their role and what they have to
cover. The surgeon should not be the only one talking and asking for
confirmation to yes-or-no questions. Each team member must
announce their name and position before going over their part of the
checklist. Here are the roles we've assigned:
• The circulating nurse announces the patient's name and date of birth
and the scheduled procedure, including the specific location of the surgi-
cal site. She alerts the team to any allergies the patient might have and
confirms that pre-op antibiotics were administered on time.
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