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      Utilization of surgical safety checklists by urological surgeons in Germany: a nationwide prospective survey

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          Abstract

          Objectives

          We aimed to investigate the contemporary usage rate and habits of the WHO Surgical Safety Checklist (SSC) in German urological departments.

          Methods

          We designed a 26-item questionnaire that was sent to all urological departments in Germany. The primary aim of this study was to evaluate the usage rate of the SSC. Secondary aims were to compare perioperative characteristics of users vs. non-users of the SSC and to assess circumstances of the SSC application.

          Results

          A total of 213 of 234 (91 %) urological departments were users of the SSC, and 21 (9 %) were non-users. SSC users had more often a standard protocol, took less time and had fewer people involved for checking perioperative patient data compared to non-users. Financial budgeting for the SSC existed in 55 (24 %) departments and for patient safety in 73 (32 %) departments.

          Conclusions

          The usage rate of the SSC in urological departments in Germany is high despite restricted financial budgeting. Users of the SSC profit by saving time and manpower for checking perioperative patient data.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13037-015-0082-5) contains supplementary material, which is available to authorized users.

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          Most cited references19

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          A guide for the design and conduct of self-administered surveys of clinicians.

          K. E.A. Burns, M. Duffett, M. E. Kho … (2008)
          Article 0 comments Cited 341 times – based on 0 reviews     Review now
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            Effect of a comprehensive surgical safety system on patient outcomes.

            Eefje N de Vries, Hubert A Prins, Rogier Crolla … (2010)
            Adverse events in patients who have undergone surgery constitute a large proportion of iatrogenic illnesses. Most surgical safety interventions have focused on the operating room. Since more than half of all surgical errors occur outside the operating room, it is likely that a more substantial improvement in outcomes can be achieved by targeting the entire surgical pathway. We examined the effects on patient outcomes of a comprehensive, multidisciplinary surgical safety checklist, including items such as medication, marking of the operative side, and use of postoperative instructions. The checklist was implemented in six hospitals with high standards of care. All complications occurring during admission were documented prospectively. We compared the rate of complications during a baseline period of 3 months with the rate during a 3-month period after implementation of the checklist, while accounting for potential confounders. Similar data were collected from a control group of five hospitals. In a comparison of 3760 patients observed before implementation of the checklist with 3820 patients observed after implementation, the total number of complications per 100 patients decreased from 27.3 (95% confidence interval [CI], 25.9 to 28.7) to 16.7 (95% CI, 15.6 to 17.9), for an absolute risk reduction of 10.6 (95% CI, 8.7 to 12.4). The proportion of patients with one or more complications decreased from 15.4% to 10.6% (P<0.001). In-hospital mortality decreased from 1.5% (95% CI, 1.2 to 2.0) to 0.8% (95% CI, 0.6 to 1.1), for an absolute risk reduction of 0.7 percentage points (95% CI, 0.2 to 1.2). Outcomes did not change in the control hospitals. Implementation of this comprehensive checklist was associated with a reduction in surgical complications and mortality in hospitals with a high standard of care. (Netherlands Trial Register number, NTR1943.).
            Article 0 comments Cited 208 times – based on 0 reviews     Review now
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              Hospital costs associated with surgical complications: a report from the private-sector National Surgical Quality Improvement Program.

              P Taheri, L. Chen, F Khuri … (2004)
              The National Surgical Quality Improvement Project (NSQIP) has reduced morbidity rates in Veterans Affairs Hospitals. As the NSQIP methods move to private-sector hospitals, funding responsibilities will shift to the medical center. The objective of the current study was to calculate hospital costs associated with postoperative complications, because reducing morbidity may offset the costs of using the NSQIP. Patient data were obtained from a single private-sector center involved in the NSQIP from 2001 to 2002 (n=1,008). Cost data were derived from the hospital's internal cost-accounting database (TSI; Transitions Systems Inc). Total hospital costs associated with both minor complications and major complications were calculated. Multiple linear regression was used to determine the cost of each type of complication after adjusting for patient characteristics. Rates of minor complications (6.3%, 64 events) and major complications (6.6%, 67 events) were similar. Median hospital costs were lowest for patients without complications (4,487 dollars) compared with those with minor (14,094 dollars) and major complications (28,356 dollars) (p<0.001). After adjusting for differences in patient characteristics, major complications were associated with an increase of 11,626 dollars (95% CI, 9,419 dollars to 13,832 dollars; p<0.001). Minor complications were not associated with increased costs in the adjusted analysis. Given the substantial costs associated with major postoperative complications, reducing morbidity may provide sufficient cost savings to offset the resources needed to participate in the private-sector expansion of the NSQIP.
              Article 0 comments Cited 167 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Hendrik Borgmann: +49 176 61502875 , borgmann.hendrik@gmail.com
                Sarah Helbig: helbig.sarah@gmail.com
                Michael A. Reiter: michoreiter@gmail.com
                Tanja Hüsch: tanja.huesch@kgu.de
                David Schilling: schilling_david@hotmail.com
                Igor Tsaur: igor.tsaur@kgu.de
                Axel Haferkamp: axel.haferkamp@kug.de
                Journal
                Journal ID (nlm-ta): Patient Saf Surg
                Journal ID (iso-abbrev): Patient Saf Surg
                Title: Patient Safety in Surgery
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1754-9493
                Publication date (Electronic): 10 November 2015
                Publication date PMC-release: 10 November 2015
                Publication date Collection: 2015
                Volume: 9
                Electronic Location Identifier: 37
                Affiliations
                Department of Urology and Pediatric Urology, University Hospital Frankfurt, Germany, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
                Article
                Publisher ID: 82
                DOI: 10.1186/s13037-015-0082-5
                PMC ID: 4641404
                PubMed ID: 26561502
                SO-VID: d89e1687-b8cb-4d3b-9fe3-b6000ea1b7e1
                Copyright © © Borgmann et al. 2015
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 19 August 2015
                Date accepted : 2 November 2015
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2015

                ScienceOpen disciplines: Surgery
                Keywords: patient safety,communication,quality management,risk reduction,urology
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: patient safety, communication, quality management, risk reduction, urology

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