Webinar 10: Preparation for Expanding to Full Implementation

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Webinar 10Preparation for Expanding to Full
Implementation
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Summary of Last Weeks Call

• Importance of creating a checklist demonstration
  video.
• The Safe Surgery 2015 South Carolina Video
  Competition. Create a video using your hospitals
  checklist and/or a video of a poorly done JC
  Timeout.
• Hospitals shared their experiences implementing
  the checklist. In particular
• Preparing surgical teams for testing the
  checklist.
• Engaging skeptical colleagues in this process.
• Completing the culture survey in your hospital.
  Strategies to use when administering the survey
  in paper form.

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How Did the Homework Go?
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Homework to Date Slide 1 of 4

• Gather an implementation team consisting of at
  least one administrator, anesthesia provider,
  nurse, and surgeon.
• Designate if your hospital will be participating
  in the research portion of this project.
• Schedule a time and venue for a meeting to take
  place in 8-10 weeks.
• Read background materials on the checklist and
  look at safesurgery2015.org website.
• Create a list using the excel template provided
  to you of all of the OR staff, physicians, and
  techs. This template asks for names, titles, and
  email addresses. If you are part of the research,
  please send us this spreadsheet.
• Send us a picture of your checklist
  implementation team.

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Homework to Date Slide 2 of 4

• Start/Continue to administer the culture survey.
• Modify the checklist for your hospital and test
  it using table top simulation and with your
  checklist implementation team in 1 case for 1
  day.
• Have the same team use the checklist in every
  case for one day. Modify as necessary and send us
  your checklist.
• Work with an additional surgical team to test the
  checklist in as many surgical cases as you can.
  Modify the checklist as necessary and send us a
  copy of your checklist.
• Use the Surgical Safety Checklist Observation
  Tool (Tool 4) in the cases that are testing the
  checklist.

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Homework to Date Slide 3 of 4

• Members of the implementation team need to
  complete the web-based training for the teamwork
  observation tool (Tool 3).
• Identify departmental meetings to have the
  implementation team speak at following June 28th.
• Use the OR Personnel list that you created for
  the administration of the culture survey and
  assign members of the implementation team to talk
  to everybody individually over the next couple of
  weeks.
• Identify possible skeptics and make a point to
  talk to them before you hold a large meeting, if
  possible.
• Think about ways to advertize the checklist in
  your hospital in preparation for the roll-out.

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Homework to Date Slide 4 of 4

• Create a demonstration video using your
  hospitals version of the South Carolina Surgical
  Safety Checklist. (All hospitals should do this).
• Finalize your hospitals version of the
  checklist.
• Decide if the checklist will be used in poster or
  paper form in your ORs. If your hospital will be
  using posters, look into options to have them
  made.
• Optional Homework
• If you want to be part of the video competition,
  create and send your hospitals checklist
  demonstration video and/or video of a poorly done
  Joint Commission Time-Out to our team.

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Todays Topics

• Creating timelines and setting goals for your
  checklist implementation.
• Prioritizing surgical specialties for the
  roll-out.
• Displaying the checklist in the OR.

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This Weeks Poll

1. How will you advertise the checklist in your
   hospital?
2. How are you planning on displaying the checklist
   in your OR?

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Basic Planning Principles

• Arrange things in order of anticipated
  difficulty. Start with the surgeon or service
  that you think will be the most accepting.
• Use your OR Personnel Spreadsheet and rank the
  services.
• Create a timeline.
• Be flexible.
• Give enough time to do the work. It always takes
  longer than people initially think.
• Assign a member of the checklist implementation
  team to the area that will be using the
  checklist. They will be available to talk to
  surgical teams and trouble shoot any problems.

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Small Hospitalslt 4 ORs

• One room/surgeon each day.
• Talk to everybody on the surgical team before
  they use the checklist for the first time.

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Example Timeline for Small Hospital
Date Service Implementation Team Member Assigned to talk to them Surgeon Members of the Surgical Team Anticipated Difficulty
Monday, July 11th General Sue Dr. Smith Rita, Mandy, and Dr. Jones. Easy
Tuesday, July 12th General Sue Dr. Berry Joanne, Rick, and Dr. Foster Easy
Wednesday, July 13th General Katie Dr. Jones Rita, Mandy, and Dr. Jones Moderate
Thursday, July 14th, Ortho Dr. Strauss Dr. Smink Joanne, Rick, and Dr. Foster Difficult
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Medium to Large Hospitals

• one service per week.
• Talk to every member of the surgical team prior
  to when they use the checklist for the first
  time.

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Service Line Roll-out Timeline
Week Service Difficulty
Week 1 General Surgery Easy
Week 2 Plastic Surgery Easy
Week 3 Transplant Surgery Easy
Week 4 Trauma Surgery Moderate
Week 5 Urology Moderate
Week 6 ENT Difficult
Week 7 Cardio-Thoracic Surgery Difficult
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Example of a given Week
Date Service Implementation Team Member Assigned to talk to them Surgeon Members of the Surgical Team Anticipated Difficulty
Monday, July 11th General Mary Dr. Moore CN Joan Anderson Scrub Suzanne White CRNA Chris Jones Easy
Tuesday, July 12th General Eric Dr. Berry CN Linda Johnson Scrub Lisa Jackson Anesthesiologist Paul Harris Easy
WednesdayJuly 13th General Eric Dr. Jones CN Rita Moore Scrub Judy Allen CRNA Debra Hughes Moderate
Thursday, July 14th General Dr. Strauss Dr. Smink CN Joan Anderson Scrub Ann Fisher Anesthesiologist Randall Johnson Difficult
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Collect Feedback

• Appoint a member of the implementation team to be
  the point of contact for individuals to talk to.
• If you are using a paper checklist have a space
  to write comments on the back.
• Set-up a short survey and ask people to complete
  it throughout the entire implementation process.

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The System Needs to Accommodate Feedback

• If an individual raises an issues you need a
  system in place to fix it.
• Increases buy-in.
• Motivates individuals to use the checklist and
  give feedback.

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Displaying the Checklist in the OR

• Small Scale Testing
• Paper
• Have circulator hold the checklist up in front of
  clinicians so they can read their parts aloud.

• Roll-Out
• Checklist Poster
• Electronic Medical Record
• Paper

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This Weeks Homework

• Continue/Start to administer the culture survey.
• Continue to talk with your colleagues one-on-one.
  
• Hold the meeting that you scheduled at the
  beginning of the call-series with as many
  surgical personnel that can attend.

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Materials for the Large Meeting

• We have created the following for you to use at
  your large meeting
• Presentation Template
• Presentation Template Guide and Tips
• All of these materials will be available on the
  Safe Surgery 2015 website later today.

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Large Meeting

• Share a story to show them why we want them to do
  this.
• Share the data that shows that the checklist can
  do good things.
• Show them an example of a team doing the
  checklist.
• Tell them the plan to introduce it to the OR.

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This Weeks Homework

• Continue/Start to administer the culture survey.
• Continue to talk with your colleagues one-on-one.
  
• Hold the meeting that you scheduled at the
  beginning of the call-series with as many
  surgical personnel that can attend.
• Start your checklist advertising campaign.
• Prioritize surgical specialties for the roll-out
  using your knowledge of which surgeons will be
  most receptive to the checklist.
• Create a timeline for your hospitals expansion
  and send it to the Safesurgery 2015 team at
  safesurgery2015_at_hsph.harvard.edu.
• If necessary, hold departmental meetings in the
  service that you are rolling the checklist out
  in.

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Announcements

• The date that the videos are due for the video
  competition has been moved back to August 15th.
• The winner will be announced on our last call,
  August 30th.
• Office hours is cancelled this Friday and July
  8th.
• Next week there will NOT be a Tuesday webinar.
• We are making presentations specialized for
  individuals disciplines. These will be available
  by the end of next week.
• We need your help for the culture survey. Please
  encourage your colleagues to take the survey.

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Questions
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Ask Us a Question By Using the Raise Hand Button
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Office HoursCancelled This Week and Next Week
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Next Weeks CallCancelled Happy 4th of July!
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Resources
Website www.safesurgery2015.org Email
safesurgery2015_at_hsph.harvard.edu