Improved compliance with the World Health Organization Surgical Safety Checklist is associated with reduced surgical specimen labelling errors.
OBJECTIVE
A new approach to administering the surgical safety checklist (SSC) at our institution using wall-mounted charts for each SSC domain coupled with migrated leadership among operating room (OR) sub-teams, led to improved compliance with the Sign Out domain. Since surgical specimens are reviewed at Sign Out, we aimed to quantify any related change in surgical specimen labelling errors.


METHODS
Prospectively maintained error logs for surgical specimens sent to pathology were examined for the six months before and after introduction of the new SSC administration paradigm. We recorded errors made in the labelling or completion of the specimen pot and on the specimen laboratory request form. Total error rates were calculated from the number of errors divided by total number of specimens. Rates from the two periods were compared using a chi square test.


RESULTS
There were 19 errors in 4,760 specimens (rate 3.99/1,000) and eight errors in 5,065 specimens (rate 1.58/1,000) before and after the change in SSC administration paradigm (P=0.0225).


CONCLUSIONS
Improved compliance with administering the Sign Out domain of the SSC can reduce surgical specimen errors. This finding provides further evidence that OR teams should optimise compliance with the SSC.
House Officer, Auckland District Health Board, Auckland.
Walston R
WR
Martis
Research Fellow, Department of Anaesthesiology, University of Auckland, Auckland.
Jacqueline A
JA
Hannam
Nurse Consultant, Auckland City Hospital, Auckland District Health Board, Auckland.
Tracey
T
Lee
Head of School, School of Medicine, University of Auckland, Consultant Anaesthetist, Auckland City Hospital, Auckland District Health Board, Auckland.
Alan F
AF
Merry
Head of Department, Department of Anaesthesiology, University of Auckland, Consultant Anaesthetist, Auckland City Hospital, Auckland District Health Board, Auckland.
Simon J
SJ
Mitchell
D057189:Checklist / Q000592:standards*; D054869:Clinical Audit; D019983:Guideline Adherence; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D009520:New Zealand; D009873:Operating Rooms / Q000458:organization & administration*; D061214:Patient Safety / Q000592:standards*; D012189:Retrospective Studies; D013048:Specimen Handling / Q000592:standards*; D014944:World Health Organization