Published online Dec 28, 2017. doi: 10.3748/wjg.v23.i48.8605
Peer-review started: August 31, 2017
First decision: September 13, 2017
Revised: September 27, 2017
Accepted: October 18, 2017
Article in press: October 18, 2017
Published online: December 28, 2017
To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a “checklist intervention”.
The checklist, based on previously published safety checklists, was developed and locally adapted, taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions. Structured observations of the endoscopy team’s performance were conducted before and after the introduction of the checklist. In addition, questionnaires focusing on patient participation, collaboration climate, and patient safety issues were collected from patients and staff.
A person-centered safety checklist was developed and introduced by a multi-professional group in the endoscopy unit. A statistically significant increase in accurate patient identity verification by the physicians was noted (from 0% at baseline to 87% after 10 mo, P < 0.001), and remained high among nurses (93% at baseline vs 96% after 10 mo, P = nonsignificant). Observations indicated that the professional staff made frequent attempts to use the checklist, but compliance was suboptimal: All items in the observed nurse-led “summaries” were included in 56% of these interactions, and physicians participated by directly facing the patient in 50% of the interactions. On the questionnaires administered to the staff, items regarding collaboration and the importance of patient participation were rated more highly after the introduction of the checklist, but this did not result in statistical significance (P = 0.07/P = 0.08). The patients rated almost all items as very high both before and after the introduction of the checklist; hence, no statistical difference was noted.
The intervention led to increased patient identity verification by physicians - a patient safety improvement. Clear evidence of enhanced person-centeredness or team work was not found.
Core tip: With increasing indications and more technically advanced gastrointestinal endoscopy, finding strategies to prevent adverse events is important. Standardized methods, such as checklists and promoting patient involvement, are strategies for augmented patient safety. This paper describes the development of a novel endoscopy checklist that combined patient safety and a person-centeredness approach. After the introduction of the checklist, physicians’ verifications of patients’ identities before their examinations increased significantly. However, compliance to the checklist was suboptimal, possibly due to insufficient training. With more team training for all staff members, the checklist could be a tool for increased person-centeredness and safety.