Scaling safety: The South Carolina surgical safety checklist experience (November 2018)

Summary

Proven patient safety solutions such as the World Health Organization’s Surgical Safety Checklist can be difficult to implement at scale. This article looks at a voluntary initiative launched in South Carolina hospitals in 2010 to encourage use of the checklist in all operating rooms. Hospitals that implemented the checklist by 2017 had higher levels of CEO and physician participation than comparison hospitals, and engaged more in activities such as in-person meetings and teamwork skills trainings.

The authors suggest three considerations for hospital, state and national policy makers:

1. Successful programs must be designed to engage all stakeholders (CEOs, physicians, nurses, surgical technologists, and others)
2. Offering a variety of program activities—both lower-touch and higher-touch—over the duration of the program allows more hospital and individual participation
3. Change takes time and resources