The following abstract was just submitted to the WSAVA 2023 World Congress and contains coll data from a study about a new surgery checklist in cancer cases.
Title: Enhancing Surgical Safety in Veterinary Medicine: The Importance of Surgery Checklists.
Introduction: Surgical procedures in veterinary medicine are intricate processes that demand meticulous coordination among the surgical team. Despite the significant risks involved, using surgery checklists in veterinary surgery remains uncommon. This lecture explores the importance of implementing surgery checklists in veterinary medicine, highlighting their benefits, the role of teamwork, the influence of the World Health Organization (WHO) guidelines, the structure of the checklist, and the impact of checklist implementation on veterinary professionals.
The Value of Surgery Checklists: Surgery is a collaborative effort that involves various professionals, including surgeons, anesthesia specialists, nurses, and technicians. The entire team should embrace surgery checklists to ensure a safe and efficient surgical environment. These checklists offer a systematic approach to enhancing patient safety by reducing the likelihood of errors, complications, and avoidable risks.
The Influence of the World Health Organization: The World Health Organization’s “Safe Surgery Saves Lives” initiative has pioneered surgery checklists as a vital tool to improve patient outcomes. While initially developed for human surgery, the principles apply equally to veterinary medicine. This initiative emphasizes the need for adherence to essential safety steps that minimize common and preventable surgical risks.
Structure of the Surgery Checklist: The surgery checklist, designed to be concise and straightforward, divides the surgical procedure into four phases, each corresponding to a specific time period in the surgical workflow:
1. Sign In: Before induction of anesthesia
2. Move-In: Before patient movement in the operating room
3. Time Out: Before surgical incision
4. Sign Out: During or after wound closure but before patient removal from the operating room
Each phase involves a checklist coordinator who verifies the completion of tasks before progressing to the next stage. This structured approach ensures that critical safety steps are consistently followed.
Benefits of Checklist Implementation: A survey of veterinary professionals (VSSO listserve) revealed that a significant percentage (67%, n= 48) already used surgery checklists, while others had not adopted this practice. However, we observed that many of the individual steps in the checklist were already considered routine in facilities globally, albeit often not followed comprehensively. This underscores the need for implementing surgery checklists to ensure consistency and adherence to these vital safety measures.
Impact on Veterinary Professionals: The follow-up survey results provide insights into the impact of checklist implementation on veterinary professionals. The findings suggest that surgery checklists improve communication, reduce work pressure, enhance teamwork, and better training. Most professionals felt comfortable asking questions when something was amiss and believed that patient care information was communicated effectively. However, there were still concerns about missing critical information when needed, indicating room for improvement. Moreover, the survey revealed that teamwork and training improved after checklist implementation, with a substantial percentage feeling that their facility did a good job communicating information affecting patient care. Issues such as feeling rushed while caring for patients, and the adequacy of orientation and refresher training for new staff require attention.
Conclusion: In conclusion, implementing surgery checklists in veterinary medicine ensures patient safety and minimizes avoidable risks. The World Health Organization’s emphasis on safe surgery has paved the way for adopting surgery checklists, which offer a structured approach to enhancing communication, teamwork, and training among veterinary professionals. The survey results underscore the benefits of checklist implementation while highlighting areas requiring further attention. As the WSAVA Oncology Working Group prepares to launch the WoW Cancer Surgery Checklist, the veterinary community can enhance surgical safety and patient outcomes through comprehensive surgery checklists.
Table 1 Survey with 48 veterinary surgery professionals (through the VSSO listserve)
| I use a surgery checklist | 67% |
| I encountered a near-miss event in my clinic | 52% |
| I use MMM rounds in my clinic | 44% |
| Patient care info is clearly communicated | 53% |
| I feel comfortable asking questions when something is not right | 70% |
| We have enough staff to handle the workload | 53% |
| Key information is missing when it is needed | 34% |
| We do a good job communicating information that affects patient care | 90% |
| We feel rushed when taking care of patients | 76% |
| Staff who are new to us receive adequate orientation | 50% |
| Staff get the refresher training they need | 40% |
| We work together as an effective team | 80% |
| Staff are treated fairly when they make mistakes | 85% |
| We make improvements when someone points out safety problems | 87% |
| We are good at changing processes to make sure the same patient safety problems do not happen again | 72% |
| We encourage everyone to suggest ways to improve patient safety | 75% |
| We examine near-miss events that could have harmed patients but did not | 50% |
| We provide adequate resources to improve patient safety | 64% |
Table 2. A follow-up survey with 13 veterinary surgery professionals about use of the WoW Cancer Surgery Checklist in their clinic.
| We used the checklist | 85% |
| We gave the checklist between 3-5 (5 is best) score | 90% |
| We explained the checklist to our staff | 46% |
| We had a near-miss event during the test period | 14% |
| The checklist improved the clear communication of important patient care info | 46% |
| The checklist allows to share key information about our patients as soon as it becomes available | 60% |
| The checklist allows you to do a good job communicating information that affects patient care | 70% |
| I feel rushed when taking care of patients | 30% |
| Staff who are new to this facility receive adequate orientation | 70% |
| The checklist allows us to share key information about our patients as soon as it becomes available | 30% |
| The checklist improved patient safety | 77% |
| We are treated fairly when you make mistakes | 85% |
| The checklist leads to improvements when someone points out safety problems | 45% |
| The checklist helps at changing processes to make sure the same patient safety problems do not happen again | 39% |
| Our manager embraces the use of the checklist | 60% |
| Management examines near-miss events that could have harmed patients | 60% |
| Management provides adequate resources to improve patient safety | 76% |
Global Veterinary Surgery 