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Checklist for anesthesiological process: analysis of risks.

A M Ghirardini1, E Guerra, L Serio

  • 1Cattedra e Servizio di Anestesia e Rianimazione, Policlinico di Modena, Modena, Italia - ghirap@hotmail.com.

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Summary

An anesthesiology checklist detected more patient safety failures than traditional incident reporting. This perioperative tool offers a more comprehensive analysis of medical errors during surgery.

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Area of Science:

  • Anesthesiology
  • Patient Safety
  • Healthcare Quality Improvement

Background:

  • Existing methods for analyzing adverse events in healthcare have limitations.
  • No single method is universally accepted as the standard for detecting medical process failures.

Purpose of the Study:

  • To compare the effectiveness of an anesthesiological perioperative checklist against traditional Regional Incident Reporting (RIR) in identifying and describing failures during surgical procedures.

Main Methods:

  • Analysis of Regional Incident Reporting (RIR) data, including report numbers, seriousness, and contributing factors.
  • Analysis of anesthesiological checklist data, covering report numbers, incident seriousness, contributing factors, and distribution across different surgical phases.

Main Results:

  • The anesthesiological checklist identified 135 failures (3.3%) in 2681 surgeries, compared to RIR's 0.4% reporting of only the most severe events.
  • Failures included issues with medical devices, treatments, clinical assessment, communication, medication, and documentation.
  • Most checklist-identified failures (91.1%) were resolved, with 69.6% causing no harm and 30.3% causing reversible damage.

Conclusions:

  • The anesthesiological checklist provides a more sensitive and complete framework for analyzing perioperative incidents.
  • This method enhances the detection and understanding of failures during gynecological and obstetrical surgeries.