Need another reason to do the surgical checklist?

Today I bumped into the mom of one of my son’s friends.  She had recently had surgery, knew I worked in some of our city’s operating rooms, and had a question for me about her experience: “Are things always like that?”  My heart sank as I asked, “like what?” anticipating a complaint about the amount she spent at the hospital that day, or perhaps the confusion of the process.  

Instead, she said “Do the workers in the Operating Room always introduce themselves?  Do they always check so thoroughly that I’m the right person having the right surgery? I never knew how many people were on my team!”

Oh, you cannot imagine my relief when I realized she was asking about the Checklist!  I happily explained we have been working on implementing the surgical checklist for over 18 months.  And that it is “mandatory” in all operating rooms in Saskatchewan since March, 2011.  And that I’m VERY proud to say that our current performance is 96.2% across Operating Rooms in Saskatoon Health Region.  Not just the main ORs but also our Labour and Delivery operating theatres, our Women's Health Centre, and our surgical suites in our rural regional hospital.   And just to brag a little more, we strive for perfect care with our checklists: to be compliant in our health region means we do all of the three components (checklist, which is done 99.4% of the time, timeout (99.4%), and debrief (97.2%)) with the attending surgeon, anesthesiologist, an operating room RN, and, most importantly, the patient.

She shared with me she had been in an operating room once before and remembered feeling overwhelmed by the process, the number of strangers in the room, and the feeling of not knowing what was going to happen.  But this time, she said, was completely different.  She felt calm, safe, and confident.  She really liked knowing why each person was in the room, and that they, too, had a first name.  She felt she was part of the team, and was in fact the most important person in the room.  

This person underwent what we in the medical profession would call “minor surgery” (ask the patient, there is no such thing as “minor” surgery). Very simple, not a lot of steps, no need for preoperative antibiotics, VTE prophylaxis or special instruments.  The sort of case where you might wonder whether the implementation of a surgical checklist would have a large impact.  But for this patient, using the checklist made the difference between feeling overwhelmed and scared, and feeling calm and in control.  

That’s reason enough for us to make sure we really, truly, with heart and commitment, do the surgical checklist.  For every patient, every procedure, every time.