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What is the value of the SAGES/AORN MIS checklist? A multi-institutional practical assessment

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Abstract

Background

Surgical safety checklists reduce perioperative complications and mortality. Given that minimally invasive surgery (MIS) is dependent on technology and vulnerable to equipment failure, SAGES and AORN partnered to create a MIS checklist to optimize case flow and minimize errors. The aim of this project was to evaluate the effectiveness of the SAGES/AORN checklist in preventing disruptions and determine its ease of use.

Methods

The checklist was implemented across four institutions and completed by the operating team. To assess its effectiveness, we recorded how often the checklist identified problems and how frequently each of the 45 checklist items were not completed. The perceived usefulness, ease of use, and frustration associated with checklist use were rated on a 5-point Likert scale by the surgeon. We assessed any differences dependent on timing of checklist completion and among institutions.

Results

The checklist was performed during MIS procedures (n = 114). When used before the procedure (n = 36), the checklist identified missing items in 13 cases (36.11 %). When used after the procedure (n = 61), the checklist identified missing items in 18 cases (29.51 %) that caused a delay of 4.1 ± 11.1 min. The most frequently missed items included preference card review (14.0 %), readiness of the carbon dioxide insufflator (8.7 %), and availability of the Veress needle (3.6 %). The checklist took an average of 3.6 ± 2.7 min to complete with its usefulness rated 2.6 ± 1.5, ease of use 2.0 ± 1.2, and frustration 1.3 ± 1.1.

Conclusion

The checklist identified problems in 24 % of cases that led to preventable delays. The checklist was easy to complete and not frustrating, indicating it could improve operative flow. This study also identified the most useful items which may help abbreviate the checklist, minimizing the frustration and time taken to complete it while maximizing its utility. These attributes of the SAGES/AORN MIS checklist should be explored in future larger-scale studies.

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Authors and Affiliations

  1. Department of Surgery, Carolinas HealthCare System, Charlotte, NC, USA

    Emily Benham

  2. Department of Surgery, Ochsner Clinic, New Orleans, LA, USA

    William Richardson

  3. Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA

    Jonathan Dort

  4. Department of Surgery, Naval Hospital Camp LeJeune, Camp Lejeune, NC, USA

    Henry Lin, A. Michael Tummers & Travelyan M. Walker

  5. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Dimitrios Stefanidis

Authors
  1. Emily Benham
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  2. William Richardson
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  3. Jonathan Dort
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  4. Henry Lin
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  5. A. Michael Tummers
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  6. Travelyan M. Walker
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  7. Dimitrios Stefanidis
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Corresponding author

Correspondence to Dimitrios Stefanidis.

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Disclosures

Dr. Stefanidis receives honoraria from Davol Inc. and Gore Medical and research support from Ethicon, all not relevant to this study. Dr. Lin works with a software development company to implement the MIS checklist in their software, but has no financial interest in the company. Drs. Benham, Richardson, Dort, Tummers, and Walker have no conflicts of interest or financial ties to disclose.

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Benham, E., Richardson, W., Dort, J. et al. What is the value of the SAGES/AORN MIS checklist? A multi-institutional practical assessment. Surg Endosc 31, 1821–1827 (2017). https://doi.org/10.1007/s00464-016-5179-0

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  • DOI: https://doi.org/10.1007/s00464-016-5179-0

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