From Paper to Proactive Safety: Digitalising Shift Checklists in a Paediatric Cardiac ICU

Area of Science:

• Quality Improvement in Healthcare
• Digital Health Technology
• Patient Safety

Background:

• Paediatric cardiac intensive care units (PCICUs) require rigorous shift-based safety checks for critical equipment.
• Paper-based checklists led to inconsistent compliance and accountability issues.
• A critical incident highlighted risks associated with equipment unpreparedness during emergencies.

Purpose of the Study:

• To enhance patient safety and staff readiness in a PCICU.
• To implement and sustain compliance with shift safety checks using a digital system.
• To leverage QR codes, automated reminders, and escalation for improved checklist completion.

Main Methods:

• A quality improvement project in a tertiary PCICU utilized Kotter's eight-step change model and PDCA cycles.
• A mobile-accessible digital checklist with QR codes placed on equipment was developed.
• Automated reminders and escalation protocols were integrated to ensure timely completion.

Main Results:

• Shift safety check compliance increased from 82% to 100% within six months.
• Staff satisfaction rose from 68% to over 96%.
• Equipment readiness improved, documentation became auditable, and critical equipment failures ceased.

Conclusions:

• A digital checklist system, combined with change management and a Just Culture, achieved sustained improvements in PCICU safety checks.
• This low-cost, scalable QR code solution enhances equipment readiness, real-time documentation, and auditability in critical care settings.