Call 7: Review Call and the Importance of Hospital Visits

1. Call 7: Review Call and the Importance of Hospital Visits

2. Welcome Back Happy New Year!

3. Last Call • Does our checklist meet the goals of the South Carolina Checklist? • Taking the Checklist into the OR. • Identifying the right people to use the checklist for the first time. • Preparing and teaching surgical teams how to use the checklist during testing.

4. How Did the Homework Go?

5. Homework to Date • Build an implementation team. • Schedule a time and venue for a meeting to take place after January. • Send us an email at: safesurgery2015@hsph.harvard.edu letting us know how you would like to administer the survey at your hospital. Please also include your mailing address in this email. • Download the OR Personnel Spreadsheet from our website and begin completing the information with the names, roles, and email addresses if relevant. • Review the checklist modification guide and South Carolina Checklist Template. • Modify the checklist with your implementation team and use it in a “table-top simulation”.

6. Homework to Date Continued • Test the checklist with one team and modify if necessary. • Email us a picture of your checklist implementation team. Email: safesurgery2015@hsph.harvard.edu • Identify departmental meetings to have the implementation team speak after call 10.

7. Meeting the Team Sara Singer, PhD, MBA Implementation Research Director

8. Today’s Topics • Update on the webinar specifically for surgeons. • Participant check-in. • Review the testing of the checklist and where we are going over the next couple of weeks. • Expanding the checklist from one team using it in one case to testing the checklist for an entire day with one team. • Hospital Visits by the South Carolina Hospital Association. • Teaching teams to use the checklist with a demonstration video from your hospital.

9. Participant Check-In

10. Poll 1: Have you built an implementation team that consists of at least one Anesthesiologist/CRNA, Circulating Nurse, Scrub Tech, Surgeon, and Administrator? • Yes • No, we are still looking for physician champions to lead this effort.

11. Baptist Easley Hospital Beaufort Hospital Georgetown Hospital Please Send Us a Picture of Your Hospital’s Checklist Implementation Team Palmetto Health, Richland

12. Poll 2: Have You Tested the Checklist in the OR with One Surgical Team? • Yes • No, but we will be doing it soon • No, we are not planning on testing it in the OR in the immediate future.

13. Poll 3: What Was the Result of Testing the Checklist in the OR? • We added new items to our checklist. • We changed the wording on the checklist. • We removed some of the items that we had on our checklist. • The checklist worked well and we didn’t have to modify the checklist.

14. Poll 4: What is Your Checklist Like?Part I 1. Does your surgical checklist have three phases in the OR, before induction of anesthesia, before skin incision, and before the patient leaves the room? 2. Are the items on the checklist meant to be read aloud, without reliance on memory, so all members of the team can hear them? 3. Does every person that is present in the operating room have the opportunity to say something before skin incision, at a minimum they introduce themselves by name and role or state that they are ready to proceed? (This includes perfusionists, surgical assistants, PAs, residents, observers, manufacturer representatives, and other observers)

15. Poll 5: What Is Your Checklist Like? Part II 4. Will the surgeon share an operative plan and discuss: anticipated blood loss, expected duration of the procedure, possible difficulties, and implants or special equipment needed for the case with the entire team before skin incision? 5. Will the nurses and surgical techs discuss with the entire team their concerns about the patient? 6. Will the anesthesia providers discuss with the entire team the anesthetic plan and airway or other concerns?

16. Poll 6: What Is Your Checklist Like?Part III • Will the surgeon ask the entire team to speak up if they have any concerns during the case? • Before the patient leaves the OR will ALL members of the surgical team discuss equipment problems that need to be addressed, key concerns for recovery and management, and anything that could have been done better to make the case safer or more efficient?

17. The Next Stop on Our Journey:Testing the Checklist With One Team For One Day

18. Testing the Checklist with One Team For One Day • This might be a different team than the one that you originally tested the checklist with. • Pick enthusiastic people to test the checklist with. • Talk to everybody beforehand. • Have a member of the implementation in the room or nearby so they can get everybody’s feedback and/or troubleshoot problems.

19. What To Focus Your Efforts On Over the Next Couple of Weeks • Continue to test the checklist at your hospital. This time test it for an entire day with one OR Team. • The next two webinars are extremely important, but we are not going to ask you to do a lot of homework. • We would like to get all of the culture surveys back from you before mid February so we can provide you with the results at a time that helps you with the checklist implementation. • In order to do this we need all of your information from you. Lizzie will call you or send you an email tomorrow with the information that we need to move forward with the surveys.

20. Hospital VisitsSCHA Team Ashley Kay Childers, PhD Systems Engineer SCHA Clemson University Kimberly Hubbard, MHA Project CoordinatorSCHA

21. Safe Surgery 2015: SC Site Visits • Safe Surgery 2015: SC team members visit and observe the checklist in action! • Would like to visit each hospital at least once • Logistics are up to you • We learn from you – as well as from observing in the operating rooms and speaking with staff • Verbal debrief on the day of the visit with a formal report to follow to discuss the strengths and opportunities for improvement

22. Benefits • Reenergize staff • Share ideas for improvement and lessons learned from other hospitals • Outside perspective on strengths and weaknesses. This usually confirms what you already new, but we also… • Immediate feedback and a hard copy report to share with your leadership and staff • Feedback to the Harvard team helps us learn about you and shape Safe Surgery 2015: SC

23. Other Information • 3-6 months later if requested • Safe Surgery 2015: SC Student project • For more information or to schedule a site visit, please email: Kimberly Hubbard : khubbard@scha.org Ashley Kay Childers: childer@clemson.edu

24. Homework • Have one team use the checklist for every case for one day and modify the checklist as needed. • Send us your hospital’s checklist and a picture of your implementation team. • Work with our team to get the information needed to administer the culture survey at your hospital.

25. ? Questions

26. Ask Us a Question By Using the Raise Hand Button

27. Next Weeks Call:Engaging Your Colleagues

28. Office Hours: Tuesday 2:00-3:00

29. Resources Website: www.safesurgery2015.org Email: safesurgery2015@hsph.harvard.edu