A Simple, 2 Question Survey is the Springboard for Transforming Operating Room Safety Culture.

Susann Camus Karen Donaldson

Alix Kite

February 19, 2015

CUSP & NSQIP – how they connect

Why join CUSP

Sep/12

RCH

joins

CUSP

Pilot

Project

Dec/14

PAH

In-Patient

Unit,

ERH join

CUSP

Nov/13

RCH

new

CUSP

Apr/14

CUSP

Kick-

off

May/14

PAH

OR

CUSP,

ARH

CUSP

Jun/1

4

RMH

July/14

BH

2

1) How we can cause harm to the next patient?

2) How we can prevent harm to the next patient?

Purpose

Who completes it

3

4

5

Establishing common ground in a complex

system

o Large OR/PACU

o Multiple specialties

o Complex patients

o Sophisticated surgeries

Insert a graphic,

possibly of a complex

system or a spaghetti

diagram?

6

7

Holding bins in the OR

o Keep it clean

Scary signs

o Prevent scrubs being taken

by non-OR staff

Normothermia study

o Are we keeping them warm

enough? YES!

Insert graphic

– surgical thongg?

8

How do we make the Surgical Checklist

shorter ?

streamlined ?

relevant ?

It had to be BRIEF

The surgical brief

9

• T – This our patient? Identifiers,

Consent, Imaging, History, Meds

• H – High Risk Attributes? ASA,

Allergies, Difficult Airways, VTE, Anticipated Blood

Loss, Prophylaxis

• O – Overview Procedure, Site, Side, Critical

Steps

• N – Nursing Concerns Equipment,

Positioning, Staffing

• G – Gas Passer (Anaesthesia)

Review Airway or IV access issues, critical

resuscitation plans, redosing Abx

• G – Got Issues? Final pre-incisional check 10

Smaller site

Comfortable in practice

Why change?

Need more information

2 question survey provided the mechanism

11

Excessive traffic in and out of the OR

Sterile wrappers prone to tearing

Complacency

with pre op

checklist

Checking

cataract

lenses

12

‘Great Catches’ celebrated

Communication improvement within

and with outside units

Best practices being

followed

Re-focused the team

on the patient

13

Survey as catalyst

◦ Process change

◦ Behaviour change

◦ Communications

◦ Teamwork

◦ Better workplace for staff

◦ Surgeons, Anesthesiologists feel

they have a greater voice

◦ Improved patient outcomes

14

FH CUSP Teams

◦ Team members

◦ Hospital OR/PACU/Surgical Unit Nursing Staff,

Unit Clerks

◦ Physicians, Anesthesiologists, Residents,

Surgeon Assists, Housekeepers, etc

BCPSQC

ACS/NSQIP/CUSP

15