Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Patient-centered perioperative checklists to improve surgical care quality

Fred E. Shapiro, DO
Physician
April 4, 2016
109 Shares
Share
Tweet
Share

american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

With the recent expansion of ambulatory surgical centers, the number of outpatient surgical procedures has increased at an exponential rate. Coupled with the rise in volume has been the increasing complexity of procedures and underlying diseases of patients. The convergence of these factors represents a challenging environment for physicians to deliver safe, high-quality and efficient care.

One potential tool to improve patient safety is the surgical safety checklist. The World Health Organization (WHO) has guidelines in place that have dramatically improved surgical safety, including checklists for health care professionals to use prior to anesthetic delivery, before incision and prior to the patient leaving the operating room (OR). While these checklists have been very effective at improving safety, they have historically focused on the health care team. Few checklists have been investigated and developed that feature prominent patient involvement. A pilot study that was conducted utilizing 35 patients and 52 providers revealed that 94 percent of patients and 83 percent of providers found a checklist to be beneficial in the perioperative setting. Patients felt it would improve their medical knowledge, alleviate anxiety and help them prepare for postoperative recovery. Of note, highly-motivated patients have been linked to higher satisfaction scores.

As pioneers and innovators of safety-based protocols in the OR, the anesthesiology specialty is primed to address the future challenges of patient safety in the ambulatory setting.  To create a surgical safety checklist that encourages patient participation, the American Society of Anesthesiologists (ASA) is developing a patient checklist that will highlight questions patients should ask medical providers before undergoing an outpatient procedure with the goal of improving patient empowerment and satisfaction, while reducing perioperative complications. The quality of the checklist questions will be assessed though the use of a consensus study. Data will be collected and analyzed to develop a consensus opinion of the medical community and the patient population on the optimal topics for patients to engage their health care providers prior to undergoing an outpatient surgical procedure. Topics patients are encouraged to discuss may include who will be the anesthetic provider, ways to manage  chronic medical conditions, facility accreditation, the ideal location for surgery, equipment and protocols for addressing emergency situations, plans for monitoring vital signs and managing post-operative pain, and written instructions to follow after discharge. Patient satisfaction will also be determined with a follow-up survey.

While the initial goal will be to develop a checklist for patients to discuss with their surgeon and physician anesthesiologist prior to surgery, the checklist will also be tested at multi-institutional sites, via survey, highlighting patient satisfaction scores.  A later validation study will be conducted using quality metrics (e.g. unanticipated hospital admission, poor pain control, nausea and vomiting, contradictory anesthetic expectations) to assess whether the use of a patient checklist can be effective to decrease complications and improve patient outcomes.

By establishing a patient surgical safety checklist at your institution, health care professionals can further advance safe, high-quality efficient care.  Tools that help physicians and patients better optimize safety during anesthesia and surgery should be embraced in light of the current value-based health care environment. Communicating a clear perioperative plan before, during and after surgery is essential, and using a surgical checklist and providing written instructions are more effective than relying on patient memory.  As physicians, we understand that patient safety is our number one priority, and we need to challenge ourselves to improve outcomes.

Fred E. Shapiro is an anesthesiologist.

Image credit: Shutterstock.com

Prev

How everyday people catch sexually transmitted infections

April 4, 2016 Kevin 5
…
Next

Ask your doctors how they are doing. Please.

April 5, 2016 Kevin 26
…

Tagged as: Surgery

Post navigation

< Previous Post
How everyday people catch sexually transmitted infections
Next Post >
Ask your doctors how they are doing. Please.

More by Fred E. Shapiro, DO

  • a desk with keyboard and ipad with the kevinmd logo

    An informed patient is a safer patient

    Fred E. Shapiro, DO

Related Posts

  • Do quality metrics really improve patient care?

    Fred N. Pelzman, MD
  • Physicians and patients must work together to improve health care

    Michele Luckenbaugh
  • More physician responsibility for patient care

    Michael R. McGuire
  • The ultimate in patient empowerment: advance care planning

    Patricia McTiernan
  • The folly of using money to improve health care quality

    Robert Pearl, MD
  • Patient care is not a spectator sport

    Jim Sholler

More in Physician

  • The hidden gems of health care: Unlocking the potential of narrative medicine

    Dr. Najat Fadlallah
  • The dark side of immortality: What if we could live forever?

    Ketan Desai, MD, PhD
  • It’s time for C-suite to contract directly with physicians for part-time work

    Aaron Morgenstein, MD & Corinne Sundar Rao, MD
  • From rural communities to underserved populations: How telemedicine is bridging health care gaps

    Harvey Castro, MD, MBA
  • From solidarity to co-liberation: Understanding the journey towards ending oppression

    Maiysha Clairborne, MD
  • Finding peace through surrender: a personal exploration

    Dympna Weil, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Why it’s time to question medical traditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden gems of health care: Unlocking the potential of narrative medicine

      Dr. Najat Fadlallah | Physician
    • The realities of immigrant health care served hot from America’s melting pot

      Stella Cho | Policy
    • The dark side of immortality: What if we could live forever?

      Ketan Desai, MD, PhD | Physician
    • Lazarus: the dead man brought back to life

      William Lynes, MD | Conditions
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Doc Moms, Mind the Gap -- $3M Earning Difference by Sex
  • Clinical Note Writing App Powered by GPT-4 Set to Debut This Year
  • Helping Patients Get Fit -- One Walk at a Time
  • TB Cases Rebound to Near Pre-Pandemic Levels, CDC Data Show
  • Marginalized Groups May Benefit More From Decreasing Air Pollution

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Why it’s time to question medical traditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden gems of health care: Unlocking the potential of narrative medicine

      Dr. Najat Fadlallah | Physician
    • The realities of immigrant health care served hot from America’s melting pot

      Stella Cho | Policy
    • The dark side of immortality: What if we could live forever?

      Ketan Desai, MD, PhD | Physician
    • Lazarus: the dead man brought back to life

      William Lynes, MD | Conditions
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Patient-centered perioperative checklists to improve surgical care quality
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...