T y Cobb Regional Medical Center P rocedural Harm

1. Ty Cobb Regional Medical CenterProcedural Harm

2. Who we are • 56 bed rural hospital • About 200 surgical cases per month • Majority of cases are Outpatient

3. What we had • Utilized the AORN Comprehensive Checklist • Used sporadically • Placed in basket in Recovery, not on chart • When used, not filled in completely • No defined responsibility for each section • Checklist fatigue

4. What we did • Talked to staff about problems with checklist • Adopted WHO Safe Surgery Checklist • Provided education • Computerized form

5. Obstacles • Time • IT dept • Avoid creating extra work

6. Successes • Still no procedural harms • Front line staff have a voice • Increased interaction involving OR

7. Results • E-form consistently completed correctly • Renewed focus on Patient Safety

8. What we learned • Involve front line staff from the very beginning • Take their concerns seriously • Adding another check-off space is not always the best answer – less may be more • Some departments are more isolated than others • Clinical departments really do want to provide the best care for their patients

9. Contacts • Sheri Fields – OR Nurse Manager sheri.fields@tycobbhealthcare.com • Tina Thomas – Quality Director tina.thomas@tycobbhealthcare.com