Key result
The WHO Surgical Safety Checklist is often perceived as an 'add-on' rather than integrated into existing risk management strategies, compromising its fidelity and limiting its clinical effectiveness.
Why the study?
How frontline personnel integrate the WHO Surgical Safety Checklist with pre-existing perioperative clinical risk management remains underexplored.
Observational (n=17)
Yes
When the WHO Surgical Safety Checklist is perceived as an 'add on' rather than integrated into existing risk management strategies, its fidelity is compromised, limiting its clinical effectiveness.
SSC integration with existing perioperative risk management remains underexplored; leaves open how checklist optimization can improve safety.
Background The World Health Organization (WHO) Surgical Safety Checklist (SSC) has demonstrated beneficial impacts on a range of patient- and team outcomes, though variation in SSC implementation and staffʼs perception of it remain challenging. Precisely how frontline personnel integrate the SSC with pre-existing perioperative clinical risk management remains underexplored – yet likely an impactful factor on how SSC is being used and its potential to improve clinical safety. This study aimed to explore how members of the multidisiplinary perioperative team integrate the SSC within their risk management strategies. Methods An ethnographic case study including observations (40h) in operating theatres and in-depth interviews of 17 perioperative team members was carried out at two hospitals in 2016. Data were analysed using content analysis. Results We identified three themes reflecting the integration of the SSC in daily surgical practice: 1) Perceived usefullness; implying an intuitive advantage assessment of the SSCʼs practical utility in relation to relevant work; 2) Modification of implementation; reflecting performance variability of SSC on confirmation of items due to precence of team members; barriers of performance; and definition of SSC as performance indicator, and 3) Communication outside of the checklist; including formal- and informal micro-team formations where detailed, specific risk communication unfolded. Conclusion When the SSC is not integrated within existing risk management strategies, but perceived as an “add on”, its fidelity is compromised, hence limiting its potential clinical effectiveness. Implementation strategies for the SSC should thus integrate it as a risk-management tool and include it as part of risk-management education and training. This can improve team learning around risk comunication, foster mutual understanding of safety perspectives and enhance SSC implementation.
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Wæhle et al. (2020) conducted an observational in Perioperative care (n=17). WHO Surgical Safety Checklist was evaluated on Integration of the SSC within risk management strategies. The WHO Surgical Safety Checklist is often perceived as an 'add-on' rather than integrated into existing risk management strategies, compromising its fidelity and limiting its clinical effectiveness.
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