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General Orthopaedics

THE EFFECT OF WHO SURGICAL CHECKLIST ON THEATRE EFFICIENCY

The South West Orthopaedic Club (SWOC) Spring Meeting



Abstract

The WHO surgical safety checklist was introduced at Derriford Hospital in 2009. Evidence of the effect on efficiency has been slow to appear in the literature.

Using a standardised, locally modified WHO surgical safety checklist theatre list capacity, start and finish times as well as time between cases was measured in 4 elective orthopaedic theatres. Data from 3 successive years was analysed retrospectively: prior to checklist introduction, during checklist introduction and routine checklist use.

Data was analysed using the One-Way ANOVA with post-hoc Tukey test. The number of cases per list showed a statistical difference from Year 1–2 and this increase was sustained in Year 3. The number of delayed starts showed no difference between Year 1&2, followed by a statistically significant decrease in Year 3. The number of late finishes showed a statistical difference from Year 1–2 and this decrease was sustained in Year 3. However, the number of lost minutes between cases showed no difference between Year 1&2, followed by an increase in Year 3.

This study demonstrates that pre-list briefings combined with the WHO surgical checklist can improve theatre list capacity and prompt starts, reduce the number of overruns, however fails to improve turnaround time between cases.