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dc.contributor.authorWeller JMen_US
dc.contributor.authorJowsey Ten_US
dc.contributor.authorSkilton Cen_US
dc.contributor.authorGargiulo DAen_US
dc.contributor.authorMedvedev ONen_US
dc.contributor.authorCivil Ien_US
dc.contributor.authorHannam JAen_US
dc.contributor.authorMitchell SJen_US
dc.contributor.authorTorrie Jen_US
dc.contributor.authorMerry AFen_US
dc.description.abstractWhile the WHO Surgical Safety Checklist (the Checklist) can improve patient outcomes, variable administration can erode benefits. We sought to understand and improve how operating room (OR) staff use the Checklist. Our specific aims were to: determine if OR staff can discriminate between good and poor quality of Checklist administration using a validated audit tool (WHOBARS); to determine reliability and accuracy of WHOBARS self-ratings; determine the influence of demographic variables on ratings and explore OR staff attitudes to Checklist administration. DESIGN: Mixed methods study using WHOBARS ratings of surgical cases by OR staff and two independent observers, thematic analysis of staff interviews. PARTICIPANTS: OR staff in three New Zealand hospitals. OUTCOME MEASURES: Reliability of WHOBARS for self-audit; staff attitudes to Checklist administration. RESULTS: Analysis of scores (243 participants, 2 observers, 59 cases) supported tool reliability, with 87% of WHOBARS score variance attributable to differences in Checklist administration between cases. Self-ratings were significantly higher than observer ratings, with some differences between professional groups but error variance from all raters was less than 10%. Key interview themes (33 interviewees) were: Team culture and embedding the Checklist, Information transfer and obstacles, Raising concerns and 'A tick-box exercise'. Interviewees felt the Checklist could promote teamwork and a safety culture, particularly enabling speaking up. Senior staff were of key importance in setting the appropriate tone. CONCLUSIONS: The WHOBARS tool could be useful for self-audit and quality improvement as OR staff can reliably discriminate between good and poor Checklist administration. OR staff self-ratings were lenient compared with external observers suggesting the value of external audit for benchmarking. Small differences between ratings from professional groups underpin the value of including all members of the team in scoring. We identified factors explaining staff perceptions of the Checklist that should inform quality improvement interventions.en_US
dc.subjectSurgical Safety Checklisten_US
dc.subjectpatient safetyen_US
dc.subjectquality improvementen_US
dc.titleImproving the quality of administration of the Surgical Safety Checklist: a mixed methods study in New Zealand hospitals.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleBMJ Openen_US
dc.description.affiliatesUniversity of Aucklanden_US
dc.description.affiliatesAuckland City Hospitalen_US
dc.type.studyortrialRandomized Controlled Clinical Trial/Controlled Clinical Trialen_US
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
Appears in Collections:Scholarly and Clinical
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