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Interface transition checklists in spinal surgery.

Pamela Kantelhardt¹, Alf Giese¹, Sven R Kantelhardt¹

¹Department of Neurosurgery, University Medical Centre, Johannes-Gutenberg University, Langenbeckstr. 1, D-55131 Mainz, Germany.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care

|June 11, 2016

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Implementing quality tools like pre-admission and preoperative checklists in neurosurgery requires more than just introduction. Sustained success depends on accompanying measures such as clear standards and staff training for improved patient safety and workflow efficiency.

Area of Science:

Healthcare Quality Improvement
Patient Safety in Neurosurgery

Background:

Quality tools, including pre-admission and preoperative checklists, have been promoted to enhance patient safety and process efficiency in healthcare.
Surgeons traditionally focused on surgical outcomes, but the introduction of checklists aimed to address broader process improvements.

Purpose of the Study:

To assess the efficiency of pre-admission and preoperative checklists in a neurosurgical department.
To evaluate the impact of redesigned checklists and accompanying measures on workflow and patient care.

Main Methods:

A survey of spinal instrumentation patients was conducted in 2011 (n=147) to assess initial checklist use and identify problems.
Checklists were redesigned with flanking measures, including written and online standards, and staff training.

Keywords:

anticoagulants checklists interface transition quality assessment spine surgery

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A follow-up survey in 2013 (n=162) re-evaluated the impact of these changes.

Main Results:

The use of pre-admission checklists significantly increased from 47% to 96% after the intervention.
The use of preoperative checklists decreased from 86% to 75%, but their quality and completeness improved.
The percentage of patients with completely processed preoperative checklists rose from 29% in 2011 to 43% in 2013.

Conclusions:

Checklists alone do not guarantee workflow improvement; they must be supported by measures like written standards and regular training.
The positive effects of quality tools can diminish quickly without ongoing reinforcement and clear delegation of responsibilities.
Stringent application of quality tools, when combined with supportive measures, can lead to sustainable changes in healthcare processes.