Beginning July 30, 2010, hospitals with operating rooms are required to publicly report their Surgical Safety Checklist Compliance (SSCC) compliance. The SSCC compliance indicator is the most recent addition to the Government of Ontario's public reporting regime.
What is the Surgical Safety Checklist Compliance (SSCC)?
The SSCC is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about a surgical case at three distinct stages or phases during surgery: Pre-induction (before the patient is put to sleep), Time Out (just before the first incision), and Debriefing (during or after surgical closure). The SSCC is used to facilitate operating room team discussion so that everyone is familiar about the case, and reduces reliance on memory for certain necessary interventions.
In many ways, the surgical checklist is similar to an airline pilot's checklist used just before take-off. It is a last minute check to make sure everything is in working order, all equipment is available, and everyone is ready to proceed.
Why are SSCCs important?
Operating room teams have many important steps to follow in order to ensure a safe and effective surgery for every patient, and the SSCC is a useful tool that helps facilitate good communication among the health care team.
Essentially, the checklist is about improving overall teamwork â€“ a critical factor in producing positive clinical outcomes. There is a lot of work being done in Ontario right now to improve patient safety, and the surgical safety checklist is one component.
Do hospitals use one standard SSCC? Why not?
The Canadian Patient Safety Institute has a SSCC that is generally considered the base for Ontario hospitals to use as a starting template. Hospitals may adapt or customize the checklist to fit their individual circumstances, including case-mix and the type of surgeries performed.
What type of information is included in a SSCC?
SSCCs are divided into three parts relating to different phases of a surgery, and each section of the checklist has information that is relevant to that phase.
For example, in the Pre-induction phase, there are questions about blood type, or specific equipment needed for the surgery. This helps ensure that the right blood or equipment is available before the surgery begins. The Time-Out phase contains a "double check" of the surgery site to ensure correctness. The Debriefing phase contains information that is relevant to the surgery just completed and includes recovery plans for the patient.
Information for Patients and Visitors
How are hospitals ensuring that staff use the SSCC?
Hospitals are working to create a culture of patient safety, and this involves everyone in the organization â€“ health care administration, health care professionals, and, of course, patients and families. If low compliance rates are identified, hospitals have a variety of tools and resources available to them through a Surgical Safety Checklist Implementation Toolkit that was developed by the OHA and the Ministry of Health and Long-Term Care. The toolkit contains evidence-based best practices to help hospitals improve their SSCC compliance.
More patient-specific information is available at www.ontario.ca/patientsafety and http://www.oha.com/Services/PatientSafety/Pages/Resources.aspx
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