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A Journal on Surgery

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Chirurgia 2012 June;25(3):179-83


language: English

A prospective audit cycle with an intervention of active feedback improves completion rates of the World Health Organisation Surgical Safety Checklist

Lal N., Lewington E., Nepogodiev D., Bhangu A., Pathak R.

Department of Surgery, Russells Hall Hospital, Dudley Group of Hospitals, Dudley, UK


Aim. Completion of the WHO surgical safety checklist (SSC) has been mandatory since February 2010 for patients undergoing surgery in England and Wales. This audit aimed to assess whether an audit cycle with active intervention improves completion rates of the checklist.
Methods. All general surgery patients undergoing emergency or elective operations were eligible. A pilot single day, cross-sectional, retrospective audit was followed by a 5-day prospective audit. Active intervention included presentations, verbal education and handouts to all key stakeholders and theatre staff. Re-audit of both prospective and retrospective arms followed.
Results. There were 123 and 97 patents from the prospective and retrospective arms respectively. There was improvement in the number of absent forms following intervention, which was most pronounced in the emergency groups: 17% and 37% improvement in prospective and retrospective groups respectively. Increases in the rates of completion of all sections of the form were highest in emergency groups: 23% and 40% increase in the prospective and retrospective audits respectively. In all cases, completion rates were lower in the retrospective arms compared to the prospective rates.
Conclusion. A prospective audit cycle with active intervention improves completion rates. Retrospective, cross sectional audit underestimates completion rates and should be avoided.

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