CheckPOINT: a simple tool to measure Surgical Safety Checklist implementation fidelity

作者：Rachel Moyal‐Smith, James C. Etheridge, Nathan Turley, Shu Rong Lim, Yves Sonnay, Sarah Payne, Henriëtte Smid-Nanninga, Rishabh Kothari, William R. Berry, Joaquim Michael Havens, Mary Elizabeth Brindle · 发表于：BMJ Quality & Safety · 年份：2023 · DOI：10.1136/bmjqs-2023-016030 · 被引用次数：10 · 研究领域：Patient Safety and Medication Errors、Hospital Admissions and Outcomes、Simulation-Based Education in Healthcare

INTRODUCTION: The WHO Surgical Safety Checklist (SSC) is a communication tool that improves teamwork and patient outcomes. SSC effectiveness is dependent on implementation fidelity. Administrative audits fail to capture most aspects of SSC implementation fidelity (ie, team communication and engagement). Existing research tools assess behaviours during checklist performance, but were not designed for routine quality assurance and improvement. We aimed to create a simple tool to assess SSC implementation fidelity, and to test its reliability using video simulations, and usability in clinical practice. METHODS: The Checklist Performance Observation for Improvement (CheckPOINT) tool underwent two rounds of face validity testing with surgical safety experts, clinicians and quality improvement specialists. Four categories were developed: checklist adherence, communication effectiveness, attitude and engagement. We created a 90 min training programme, and four trained raters independently scored 37 video simulations using the tool. We calculated intraclass correlation coefficients (ICC) to assess inter-rater reliability (ICC>0.75 indicating excellent reliability). We then trained two observers, who tested the tool in the operating room. We interviewed the observers to determine tool usability. RESULTS: The CheckPOINT tool had excellent inter-rater reliability across SSC phases. The ICC was 0.83 (95% CI 0.67 to 0.98) for the sign-in, 0.77 (95% CI 0.63 to 0.92) for the time-out and 0....