Checklist pioneer: Dr Atul Gawande (right) with consultant anaesthetist Yogi Amin
Dr Atul Gawande, associate professor at Harvard Medical School, hailed the ‘innovative’ work which is underway at the UCH Education Centre and said his colleagues at Harvard could learn a lot from it.
All theatre staff across UCLH will be required to complete the World Health Organisation Surgical Safety Checklist which is proven to reduce death and complications as a result of surgery.
The Trust developed its own version of the checklist which was formally launched in September and Dr Gawande popped in recently to find out more.
Theatre teams are undergoing training at the Education Centre’s simulated operating theatre: the checklist must be read out aloud in the operating theatre – before and immediately after – treating a patient. Additionally, theatre teams will be trained to carry out pre-operative briefings and de-briefings as part of the training.
The questions range from “Is the surgical site marked?” through to “Has it been confirmed that instruments, swabs and sharps counts are complete?”
Some 85 surgical teams from UCH and The Heart Hospital have completed the checklist training and it will be rolled out to other Trust hospitals in the near future.
The NHS is committed to ensuring that by January 2010 every patient will be subject to the safety checklist in operating theatres across the UK.
Dr Gawande said: “It’s fantastic. At Harvard we are trying to do much the same thing and many of the things UCLH is doing are completely innovative and we can learn from them. I’m going to steal several ideas!”
Dr Gawande - who is also a writer for New Yorker magazine, and author of the best-selling medical books Complications and Better - believes that the biggest challenge in medicine isn't discovery, but implementation.
His newest book, The Checklist Manifesto, looks to explain how simply applying well-known knowledge efficiently can make the biggest change when trying to save lives.
His checklist was inspired by those pilots use before they take off.
He added: “I am most impressed with the willingness to give surgeons and their teams half a day, or a day, off their lists to work on becoming more effective on what they are doing. That’s new.
“The second part is being able to video top people and give them feedback – that is where it becomes clear it is not about a ‘tick-box’ exercise. If it is professionals understanding how they can become more successful at what they do, that’s what saves lives and that’s what is incredibly heartening for me.”
Steve Andrews, director of programmes at the Education Centre, spoke with Dr Gawande during his visit. “He said what impressed him was UCLH’s commitment to this training and the uniqueness and creativity we have brought to the programme.
Steve added: “It has long been recognised that multi-disciplinary team based training improves communication, teamwork and overall performance. The training programme has been a massive investment in the ‘human factors’ that improve patient safety which include communication, team work, human behaviour and culture.”
The checklist’s implementation at UCLH is being led by Professor Tony Mundy, corporate medical director, and Sandra Hallett, director of quality and safety. They have worked with a team of consultant surgeons, theatre nurses and consultant anaesthetists from UCH, The Heart Hospital and the NHNN.
The NHS is committed to ensuring that by January 2010 every patient will be subject to the safety checklist in operating theatres across the UK. The implementation of the checklist in England is being led by the National Patient Safety Agency, NHS Institute for Innovation and
The UCLH version of the WHO Checklist was developed by Richard Cohen, divisional clinical director (theatres), Sally Wilson (Divisional clinical director - NHNN), Martin Hayward (consultant surgeon- Heart Hospital), Viki Mitchell (consultant anaesthetist), Jane Carthey (human factors specialist) and Therese Parker (theatre manager).