title: Impact of the World Health Organization's Surgical Safety Checklist on safety culture in the operating theatre: a controlled intervention study.
abstract: BACKGROUND
  Positive changes in safety culture have been hypothesized to be one of the mechanisms behind the reduction in mortality and morbidity after the introduction of the World Health Organization's Surgical Safety Checklist (SSC). We aimed to study the checklist effects on safety culture perceptions in operating theatre personnel using a prospective controlled intervention design at a single Norwegian university hospital.
  
  
  METHODS
  We conducted a study with pre- and post-intervention surveys using the intervention and control groups. The primary outcome was the effects of the Norwegian version of the SSC on safety culture perceptions. Safety culture was measured using the validated Norwegian version of the Hospital Survey on Patient Safety Culture. Descriptive characteristics of operating theatre personnel and checklist compliance data were also recorded. A mixed linear regression model was used to assess changes in safety culture.
  
  
  RESULTS
  The response rate was 61% (349/575) at baseline and 51% (292/569) post-intervention. Checklist compliance ranged from 77% to 85%. We found significant positive changes in the checklist intervention group for the culture factors 'frequency of events reported' and 'adequate staffing' with regression coefficients at -0.25 [95% confidence interval (CI), -0.47 to -0.07] and 0.21 (95% CI, 0.07-0.35), respectively. Overall, the intervention group reported significantly more positive culture scores-including at baseline.
  
  
  CONCLUSIONS
  Implementation of the SSC had rather limited impact on the safety culture within this hospital.
authors: Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Jonas Liesvei 65, 5021 Bergen, Norway. arvid.haugen@helse-bergen.no
authors: A S
authors: AS
authors: Haugen
authors: E
authors: E
authors: Søfteland
authors: G E
authors: GE
authors: Eide
authors: N
authors: N
authors: Sevdalis
authors: C A
authors: CA
authors: Vincent
authors: M W
authors: MW
authors: Nortvedt
authors: S
authors: S
authors: Harthug
mesh_terms: D057189:Checklist / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009664:Norway; D009873:Operating Rooms / Q000592:standards*; D015279:Organizational Culture; D061214:Patient Safety / Q000592:standards; D019990:Perioperative Care / Q000379:methods / Q000592:standards; D011446:Prospective Studies; D017751:Safety Management / Q000379:methods*; D014944:World Health Organization
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