Webinar 11:Preparation for Expansion to Full Implementation –

Planning

Summary of Last Week’s Call• Patient Safety Symposium Announcements.• Finalizing your hospital’s checklist, a few reminders. • Advertising this project in your hospital.• Two ASC’s will shared how they advertized the

checklist in their facility.

How Did the Homework Go?

Homework to Date Slide 1 of 3

• Build an implementation team.

• Schedule a time and venue for a meeting to take place after January.

• Download the OR Personnel Spreadsheet from our website and begin completing the information with the names, roles, and email addresses if relevant.

• Review the checklist modification guide and South Carolina Checklist Template.

• Modify the checklist with your implementation team and use it in a “table-top simulation”.

• Test the checklist with one team and modify if necessary.

Homework to DateSlide 2 of 3

• Email us a picture of your checklist implementation team.• Identify departmental meetings to have the

implementation team speak after call 10.• Expand the testing of the checklist to one team using the

checklist for every case for one day. Modify the checklist as necessary.

• Email us your hospital’s checklist. • If you haven’t already done so, please call or email our

team about whether you would like to administer the culture survey.

• Email everything to safesurgery2015@hsph.harvard.edu

Homework to DateSlide 3 of 3

• Identify people that you think will be skeptical of using the checklist and try to talk to them before you hold a large meeting.

• Organize and conduct one-on-one conversations.

• Create a checklist demonstration video for your hospital.

• Decide if the checklist will be used in paper or poster form.

• Finalize your hospital’s checklist, please send it to us so we can see how you made the checklist work for you.

• Think about how you will advertise the checklist.

• Mark your calendars for the April Patient Safety Symposium (April 24th – 26th)

Poll 1: How Do You Think You Will Advertize the Checklist?(Please Check All That Apply)• Posters• Bulletin Boards• Emails• Hospital Newsletters• Buttons• Competitions• Creating a Demonstration Video• Other

Poll 2: How is the Culture Survey Administration

Going?• We haven’t started yet• About half of our physicians and staff have

completed it.• We are almost done.• We are done.

Today’s Topics• Displaying the checklist: A Few Reminders.• Training your colleagues using a demonstration video

and the South Carolina video competition.• Creating timelines and setting goals for expanding the

checklist.• Reflecting on how you tested the checklist.

– What went right?– Why did it work when you tested it?

• How to scale the checklist.• Prioritizing surgical specialties for the roll-out.• Inter-hospital sharing network.

Displaying the Checklist: A Few Reminders

Displaying the Checklist• Make sure every member of the surgical

team can read a hard copy of the checklist.

• Make sure that every item on your checklist is in clear language.

• A larger checklist displayed in the OR signifies the importance of using it.

Poll 3: How Will You Display The Checklist When You Roll

it Out?(Please Check All That Apply)• Paper• Poster• EMR

Training Your Colleagues Using A Video

• A picture is worth a thousand words.• You can show people how the checklist

should by showing them.• While it is helpful it cannot be the only

method of teaching people how to use the checklist.

Video Guidelines• Do not film video over a live patient.

• Use an empty OR, conference room, or simulator.

• Shoot the video with a portable camera, phone, or anything that you have available.

Submit Your Videos for the South Carolina Checklist

Video Competition• Create a checklist demonstration video using your hospital’s

version of the checklist and/or a video of a poorly done Joint Commission “Time-Out”.

• The winning video in each category will be highlighted on the national website and will be incorporated into program presentations.

• All individuals shown in the video will need to sign a release form. Contact us to get the release form.

• All videos need to be sent to the Safe Surgery 2015: Team by April 6th, 2012.

• The winner will be announced at the April Patient Safety Symposium.

Poll 4: Are You Planning on Creating a Demonstration

Video?• Yes• No• We are still thinking about it

Reflect on What Worked When You Tested the

Checklist• Arrange things in order of anticipated difficulty. Start with the

surgeon or service that you think will be the most accepting.• Create a timeline.• Be flexible. • Give enough time to do the work. It always takes longer than

people initially think.• Assign a member of the checklist implementation team to the

area that will be using the checklist. They will be available to talk to surgical teams and trouble shoot any problems.

How Do You Organize a Checklist Roll-Out?

Use your OR Personnel Spreadsheet and rank the

services

Small Hospitals< 4 ORs

• One room/surgeon each day.• Talk to everybody on the surgical team

before they use the checklist for the first time.

Example Timeline for Small Hospital

Date Service Implementation Team Member

Assigned to talk to them

Surgeon Members of the Surgical

Team

Anticipated Difficulty

Monday, July 11th

General Sue Dr. Smith Rita, Mandy, and Dr. Jones.

Easy

Tuesday, July 12th

General Sue Dr. Berry Joanne, Rick, and Dr. Foster

Easy

Wednesday, July

13th

General Katie Dr. Jones Rita, Mandy, and Dr. Jones

Moderate

Thursday, July 14th,

Ortho Dr. Strauss Dr. Smink Joanne, Rick, and Dr. Foster

Difficult

Medium to Large Hospitals• ~ one service per week.• Talk to every member of the surgical team

prior to when they use the checklist for the first time.

Service Line Roll-out Timeline Week Service Difficulty

Week 1 General Surgery Easy

Week 2 Plastic Surgery Easy

Week 3 Transplant Surgery Easy

Week 4 Trauma Surgery Moderate

Week 5 Urology Moderate

Week 6 ENT Difficult

Week 7 Cardio-Thoracic Surgery Difficult

Example of a WeekDate Service Implementation

Team Member Assigned to talk to

them

Surgeon Members of the Surgical Team

Anticipated Difficulty

Monday, July 11th

General Mary Dr. Moore CN – Joan AndersonScrub – Suzanne White

CRNA – Chris Jones

Easy

Tuesday, July 12th

General Eric Dr. Berry CN – Linda JohnsonScrub – Lisa Jackson

Anesthesiologist – Paul Harris

Easy

WednesdayJuly 13th

General Eric Dr. Jones CN – Rita MooreScrub – Judy Allen

CRNA – Debra Hughes

Moderate

Thursday, July 14th

General Dr. Strauss Dr. Smink CN – Joan AndersonScrub – Ann Fisher

Anesthesiologist – Randall Johnson

Difficult

Collect Feedback• Appoint a member of the implementation

team to be the point of contact for individuals to talk to.

• If you are using a paper checklist have a space to write comments on the back.

• Set-up a short survey and ask people to complete it throughout the entire implementation process.

Inter-Hospital Sharing Network

Poll 5: Would You Like to Participate in the

Inter-Hospital Sharing Network?• Yes• Maybe, please send me more information• Not right now

This Week’s Homework• Continue to:

– Administer the culture survey.– Have one-on-one conversations with as many people as you

can. • Mark your calendars to attend the 2012 April Patient Safety

Symposium. • Start your checklist advertising campaign. • Prioritize surgical specialties for the roll-out using your knowledge of

which surgeons will be most receptive to the checklist.• Create a timeline for your hospital’s expansion and send it to the

Safe Surgery 2015 team. • Start holding departmental meetings in the service that you are

putting the checklist into place next.

Mark Your Calendars For The Patient Safety SymposiumColumbia, South Carolina

?Questions

Ask Us a Question By Using the Raise Hand Button

Office Hours:

Next Tuesday from 2:00-3:00

Next Call: Implementing the

ChecklistThursday, February 23rd

2:00-3:00

Resources

Website:www.safesurgery2015.org

Email: safesurgery2015@hsph.harvard.edu