1. Preparation for Expanding The Checklist: Lessons Learned from SC Hospitals

2. What We Covered & What We Asked For You To Do Prepare for having conversations with less enthusiastic team members. Organize your implementation team to conduct one-on-one conversations with everyone. Leverage staff and physician meetings to educate surgical team members about this initiative.

3. Meeting the Team Jim Sachetta Project Assistant Harvard School of Public Health

4. Poll 1: Have You Started To Have One-on-One Conversations? Yes No, but we are planning to start No, we will not be having these conversations

5. Today’s Topics Advertising the project –Overview of ways to advertise this program –Two experiences from South Carolina Ambulatory Surgery Centers –Setting up a system to advertise “catches/saves” Applying the lessons from when you tested the checklist –Training Surgical Team Members –Having one-on-one conversations –Collecting Feedback Making Sure Your Checklist Is Ready: A few reminders Creating a plan for spread

6. Advertising the Checklist

7. Advertising the Checklist in your Hospital Posters Bulletin Boards Emails Hospital Newsletters Buttons Competitions Videos

8. Remember: Advertising and Speaking at Staff Meetings Don’t Replace The One-On-One Conversation

9. Stephanie Ziesing

11. Teresa Devore Anmed Health, Medicus Surgery Center

13. Advertising Near Misses/Saves Post them on a bulletin board. If you have a hospital newsletter write about how the checklist has helped. Share saves and other success stories in meetings or huddles.

14. Planning The Roll-Out

15. Reflect on What Worked When You Tested the Checklist Arrange things in order of anticipated difficulty. Start with the surgeon or service that you think will be the most accepting. Create a timeline. Be flexible. Give enough time to do the work. It always takes longer than people initially think. Remember to engage everyone with a one-on-one conversation. Assign a member of the checklist implementation team to the area that will be using the checklist. They will be available to talk to surgical teams and trouble shoot any problems.

16. Things to Remember When Training Explain the rationale of each checklist item. Educate team members about the state- wide Safe Surgery 2015 initiative. Practice running through the checklist with them before the team uses it with a patient. Have a member of the implementation team in the OR when the team is using the checklist for the first time.

17. Use A Video To Help Train Teams A picture is worth a thousand words. You can show people how the checklist should by showing them. While it is helpful it cannot be the only method of teaching people how to use the checklist.

18. Video Guidelines Do not film video over a live patient. Use an empty OR, conference room, or simulator. Shoot the video with a portable camera, phone, or anything that you have available.

19. Keep Asking How It Is Going Appoint a member of the implementation team to be the point of contact for individuals to talk to. If you are using a paper checklist have a space to write comments on the back. Set-up a short survey and ask people to complete it throughout the entire implementation process.

20. Make Sure Your Checklist Is Ready: A Few Reminders

21. Displaying the Checklist Make sure every member of the surgical team can read a hard copy of the checklist. Make sure that every item on your checklist is in clear language. A larger checklist displayed in the OR signifies the importance of using it.

22. Use Your OR Personnel Spreadsheet To Plan Your Roll-out

23. Small Hospitals < 4 ORs One room/surgeon each day. Talk to everybody on the surgical team before they use the checklist for the first time.

24. Example Timeline for Small Hospital DateServiceImplementation Team Member Assigned to talk to them SurgeonMembers of the Surgical Team Anticipate d Difficulty Monday, July 11 th GeneralSueDr. SmithRita, Mandy, and Dr. Jones. Easy Tuesday, July 12 th GeneralSueDr. BerryJoanne, Rick, and Dr. Foster Easy Wednesd ay, July 13 th GeneralKatieDr. JonesRita, Mandy, and Dr. Jones Moderate Thursday, July 14 th, OrthoDr. StraussDr. SminkJoanne, Rick, and Dr. Foster Difficult

25. Medium to Large Hospitals ~ one service per week. Talk to every member of the surgical team prior to when they use the checklist for the first time.

26. Service Line Roll-out Timeline WeekServiceDifficulty Week 1General SurgeryEasy Week 2Plastic SurgeryEasy Week 3Transplant SurgeryEasy Week 4Trauma SurgeryModerate Week 5UrologyModerate Week 6ENTDifficult Week 7Cardio-Thoracic SurgeryDifficult

27. Example of a Week DateServiceImplementation Team Member Assigned to talk to them SurgeonMembers of the Surgical Team Anticipated Difficulty Monday, July 11 th GeneralMaryDr. MooreCN – Joan Anderson Scrub – Suzanne White CRNA – Chris Jones Easy Tuesday, July 12 th GeneralEricDr. BerryCN – Linda Johnson Scrub – Lisa Jackson Anesthesiologist – Paul Harris Easy Wednesday July 13 th GeneralEricDr. JonesCN – Rita Moore Scrub – Judy Allen CRNA – Debra Hughes Moderate Thursday, July 14 th GeneralDr. StraussDr. SminkCN – Joan Anderson Scrub – Ann Fisher Anesthesiologist – Randall Johnson Difficult

28. Where We Are Going The next call we will discuss keeping the checklist going in your hospital. Physician webinar – April 11 th 7:00-7:30 April 16 th OR Team Training: –Overview of team training, speaking up, closed loop communication, using the checklist as a teamwork tool. April 17 th Patient Safety Symposium breakout focused on sustainability and next steps. Next phase of the webinar series will start May 2 nd and we will discuss other ways of preventing SSIs and DVTs.

29. This Week’s Homework Have one-on-one conversations with everyone that works in your ORs. Create a plan for rolling out your checklist to all of your ORs. If you are ready, start expanding the use of the checklist to other teams. Mark your calendars for the following events: –Thursday April 11 th, 7:00-7:30- Special Physician Webinar –April 16 th – OR Team Training Columbia, SC –April 17 th – Safe Surgery 2015 Breakout Session: Sustaining Checklist Use

30. ? ? Questions

31. Ask Us a Question By Using the Raise Hand Button

32. Office Hours: Next Wednesday at 2:00

33. Next Call: Thursday, April 4 th Keeping the Checklist Going

34. Resources Website: www.safesurgery2015.org Email: safesurgery2015@hsph.harvard.edu