1. Testing the Checklist in the OR & Engaging Enthusiastic Colleagues

2. What We Covered & What We Asked For You To Do Modification: Review the checklist modification guide and South Carolina Checklist Template. Modify your checklist with your implementation team. Table-Top Simulation: Perform a table-top simulation using your modified checklist.

3. Poll Has Your Implementation Team Started to Modify the Checklist? –Yes –No, but we have a meeting scheduled to start modification –No, we don’t have plans to modify the checklist in the near future If yes, have you tested it, using a “Table-top Simulation”? –Yes –No

4. Meeting the Team Katie Jahreis, MPH Project Manager Harvard School of Public Health

5. Today’s Topics A quick review of the checklist communication items. Hints for finding a physician champion for your implementation team and for testing the checklist. Taking the checklist into the OR: –Displaying the checklist for testing in the OR –Identifying the right people to use the checklist for the first time. –Preparing and teaching surgical teams how to use the checklist. Engaging enthusiastic colleagues with one-on-one conversations.

6. Communication Counts The easy way out with the checklist is to remove the communication items. The communication items make the difference in American hospitals. You will know if you have your checklist right, when you hear the voices of every member of the operating room team.

8. The Next Step On Your Journey: Test the Checklist in the OR

9. Compare your modified checklist to the document “Does Our Checklist Meet the Goals of the South Carolina Checklist Template” to ensure your checklist has the greatest impact.

10. Finding an Enthusiastic Surgeon to Join Your Team and/or To Test the Checklist With Ask someone that will think the checklist is a good idea. Find an “informal leader”. The person that people look up to. Ask the nurses, if you don’t know. If your surgeon champion can’t test the checklist themselves, ask them help find a surgeon to test the checklist.

11. Physician Champion Concerns What they are being asked to do: –Help modify the checklist and potentially to help test it –Attend some of the implementation team meetings and help guide the project –Help talk to colleagues about using the checklist Time commitment

12. Displaying Your Checklist During Testing

13. Right NowEventually Have circulator hold the checklist up in front of clinicians so they can read their parts aloud. Have multiple copies of the checklist in the OR. Poster Electronic Medical Record Paper

14. Using the Checklist in the OR The team that you test the checklist with might not be the implementation team. Test with a team that has an enthusiastic anesthesia provider, nurse, surgeon, and tech. Test the checklist in a straightforward case. Have a member of the implementation team in the OR when they are using the checklist.

15. Surgical Team Engagement: The One-on-One Conversation EVERYONE who will be touched by the project should be engaged with at least 1 one-on-one conversation. For the checklist this includes: anesthesiologists, CRNAs, nurses, surgeons, techs, perfusionists, anybody else that works in the OR.

16. Nothing Replaces this Conversation Staff meetings don’t count. Emails don’t count. Posters don’t count. Bulletin boards don’t count.

17. Rules to Guide Us Teach them Show them Have them do it

18. What Does This Conversation Sound Like: A Conversation with A Nurse

19. Prior to Testing Talk to Everybody on the Surgical Team “We are bringing a new checklist into our ORs.” “This checklist builds on what we already do.” “Please help us test it.” Show him/her your hospital’s checklist with their parts highlighted If you have time run through the checklist with everybody before they bring it into the OR (or practice it in an empty OR). “I will be in the OR to help you use it for the first time.”

20. Points to Discuss When Engaging Enthusiastic Physicians (Part 1) Introduce the checklist and emphasize teamwork and communication. Everyone in our hospital tries to be safe. We are looking to you for leadership. You can set the tone for the entire operation. Other members of the surgical team will follow your patterns of communication.

21. Points to Discuss when Engaging The Enthusiastic Physician (Part 2) This is an opportunity to make your plan clear, answer questions, demonstrate openness, and professionalism. Will you help us with this work? Thank you

22. What Does This Sound Like: A Conversation with A Enthusiastic Physician

24. Reminder of What We Discussed Today Maintaining communication items when modifying the checklist. Finding physician champions for your implementation team and testing of your hospital’s checklist. Testing the checklist in the OR. Displaying your checklist during testing. Using the one-on-one conversation to engage your enthusiastic colleagues. Now You Are Ready To Test Your Checklist

25. Homework Review the one-on-one conversation script that we will send to you. Continue to modify and test the checklist with your implementation team using the tools that we have provided to you. If you are ready, use the checklist in the OR with one team for one case and modify as necessary.

26. ? ? Questions

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

28. Next Webinar March 7 th, 2013 Hospital Best Practices & Implementation Barriers

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