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Can J Rural Med. 2019 Apr-Jun;24(2):44-51. doi: 10.4103/CJRM.CJRM_27_18.

Improving patient preparedness for the operating room: A quality improvement study in Winchester District Memorial Hospital - A rural hospital in Ontario.

Author information

1
Department of Surgery, Winchester District Memorial Hospital, Winchester, ON K0C 2K0, Canada.

Abstract

in English, French

Introduction:

Full completion of the pre-operative checklist is important for proper preparation of patients before they enter the operating room (OR), thus increasing OR efficiency. It is also critical for patient safety and successful outcomes. According to various literature, full completion of pre-operative checklists varies widely between institutions and occurs anywhere between 21% and 92% of cases.[1],[2] Our pre-project audits revealed a suboptimal patient preparedness for the Winchester District Memorial Hospital (WDMH) OR, since only 25% of cases arriving at the OR had their pre-operative checklist completed in its entirety, with no omissions.

Methods:

WDMH performed a 12-month long quality improvement (QI) study to improve patient preparedness for the OR. Multiple QI initiatives were used to induce behavioural change by incorporating process mapping, enabling communication, adjusting the pre-operative checklist based on qualitative staff feedback and implementing a staff education plan. Interventions also included two post-implementation audits.

Results:

Remarkably, completion of the pre-operative checklist increased from 25% to 67% and finally to 94%. Furthermore, the previous chart's presence and completion of pre-operative orders improved from 87% to 100% and from 82% to 99%, respectively. Another significantly important secondary outcome was improvement in interdepartmental relationships and collaboration. With better communication and checklist completion rates, there came increased patient preparedness and improved efficiency.

Conclusions:

Multiple significant improvements and many additional minor improvements strongly suggest that the approaches were used were effective at improving patient preparedness.

KEYWORDS:

Checklist; Ontario; efficiency; pre-operative; quality improvement; rural hospital; surgery department

PMID:
30924460
DOI:
10.4103/CJRM.CJRM_27_18
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