Understanding check list challenges

This article addresses information raised as part of a Delphi study of NHS hospital operating theatres in England. Through a combination of closed and open-ended questions, the aim of the first Delphi study round was to solicit specific information and views on how the World Health Organization’s Surgical Safety Checklist (SSC) is currently being used in the perioperative setting, as part of a strategy to reduce surgical ‘never events’. Operating theatre managers, matrons and clinical educators (that work on the frontline of surgical care and deliver the surgical safety checklist daily), were canvassed for their views and insights, as operating theatre experts.

Participants were from the seven regions identified by NHS England. The study revealed that the majority of Trusts do not receive formal training on how to deliver the SSC, checklist champions are not always identified, feedback following a ‘never event’ is usually given and that the de-brief is the most common step missed. While the intention is not to establish whether the lack of training, cyclical learning and missing steps has led to the increased presence of never events, it has facilitated a broader engagement in the literature, as well as highlighting some possible reasons why compliance has not yet been universally achieved. Furthermore, the Delphi study is intended to be an exploratory approach to inform a more in-depth doctoral research study intended to improve patient safety in the operating theatre, inform policy making and quality improvement. 

Introduction and background context