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Scottish Patient Safety Programme . Team Culture Bundle Perioperative Workstream Lorna Ferguson. The National Peri-Op Drivers. Provide appropriate, reliable & timely care using evidence-based therapies to prevent Surgical Site Infections
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Scottish Patient Safety Programme Team Culture Bundle Perioperative Workstream Lorna Ferguson
The National Peri-Op Drivers • Provide appropriate, reliable & timely care using evidence-based therapies to prevent Surgical Site Infections • Provide appropriate, reliable & timely care using evidence-based therapies to prevent Cardiovascular Events • Create a Team Culture attuned to detecting & preventing intraoperative errors
Facilitating Team Culture to Reduce Errors • Surgical Briefing • WHO Checklist: Anaesthetic Pause; Surgical Pause; Post Procedure Pause • Debrief • Weekly Huddle
Prior to every operating list, team undertakes a Surgical Briefing • Full Anaesthetic, Surgical & Post Procedure Pause undertaken for every patient • Full team Debrief at the end of every operating list • SPSP Huddle on each site once per week
Testing & Segmentation • Tested as a bundle instead of testing the individual aspects with different pilot populations • Segmented initially by surgeons - pilot population “Early Adopters” • Visibly celebrated our successes & acknowledged our failures
Surgical Briefings • All core staff involved in the operating list • Prior to 1st patient on the list being transferred from reception into anaesthetic room. • 1 nominated person usually leads the briefing but everyone in attendance is given the opportunity to ask questions, raise concerns, clarify any issues relating to that days operating list. • Regardless of who leads, the surgeon has the responsibility & role of “setting the tone” for the day.
The Team Briefing Surgeon Scrub Practitioner Scrub Practitioner Anaesthetic Practitioner Anaesthetist Recovery Operating Dept. Support
The Team Shared Objective Surgical Briefing NO BRIEF – NO OPERATING
WHO Surgical Safety Checklist • Anaesthetic Pause • Surgical pause • Post Procedure pause
Forth Valley Surgical Safety Checklist Version 5 Date ___ /___ /___ Anaesthetic pause _________________ Surgical pause ____________________ Post procedure _________________________
The Debrief Board TH1 No beds TH4 Patient not consented TH2 Wrong procedure on operating list
Huddles • These are a quick, pro-active meetings • Held every week on both sites, same time every week • At least 1 representative from each of the scrub specialties, anaesthetics & recovery • The huddles drive our “testing” & track the progress of the changes we are making • Maintains momentum!
