Improving Surgical Ward Rounds By Way of a Checklist

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS MEDIA RELEASE

Improving Surgical Ward Rounds By Way of a Checklist

Thursday 9 May, 2013

The use of a checklist during surgical ward rounds makes a significant improvement in the consideration of key aspects of patient care, delegates to the 82nd Annual Scientific Congress (ASC) of the Royal Australasian College of Surgeons have been told.

Associate Professor Graeme Thompson, a general surgeon at Melbourne’s Western Health, said the study involved the use of a structured checklist during ward rounds and the recording of key aspects of surgical care.

“Initially, the surgical team was unaware of the nature of the observations or that a formal study was in progress,” he said.

“During the second phase team members were informed of the study, and told that a designated ‘prompter’ would alert the team when areas of care had not been considered. The observations during the two periods were analysed for statistical significance using the McNemar test.”

Following the use of a ‘prompter’ during the ward rounds, a statistically significant improvement occurred in the consideration of the majority of criteria included in the checklist.

In particular, there was a notable improvement in communication with patients (77 vs 95 per cent), and nursing staff (50 vs 80 per cent), attention to Venous Thromboembolism prophylaxis (27 vs 93 per cent), fluid balance (19 vs 99 per cent), catheters (15 vs 76 per cent) and drains (51 vs 95 per cent), reference to drug charts (74 vs 99 per cent) and discharge planning (48 vs 90 per cent).

Associate Professor Thompson said the findings leant empirical support to the intuitive observation that a structured and thorough checklist will help minimise scope for oversight and error.

In 2009 the College strongly endorsed the introduction of a checklist for use in operating theatres. It is used at three crucial points of a surgical procedure: immediately before the administration of anaesthesia, before the first incision, and before the patient is taken from the operating theatre. Based on a World Health Organisation prototype, it has since been rolled out to hospitals across Australia and New Zealand.

Approximately 1200 surgeons from New Zealand, Australia and around the world are attending the ASC, which runs from 6 to 10 May and is being held at Auckland’s Skycity/Crowne Plaza Convention Centre.

ENDS

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