Surgery Safety Checklist for Ambulatory Oral Surgical Procedures

The objective of this study was to determine the attitudes and prevalence of usage of an ambulatory Oral and Maxillofacial Surgery safety checklist among Oral Surgeons. Patient safety has emerged as an important topic in recent years. Improving surgical safety has become a high priority, in order to reduce adverse events in patients. In 2008, the WHO ‘World Alliance for Patient Safety’ developed a ‘Surgical Safety Checklist’ and published data on its efficacy. The implementation manual, published in parallel with the WHO Surgical Safety Checklist, suggests that the checklist should be adapted to fit in with local practice. The checklist is a powerful and inexpensive tool that will facilitate effective communication and teamwork. In 2013, Tufts Oral and Maxillofacial Surgery implemented a surgical safety checklist to be used in ambulatory surgical cases. The checklist was designed using the WHO ‘’Surgical Safety Checklist’ as a model and consensus option. This checklist was later adopted by OMS National Insurance Company and placed on their website. Recruitment for the survey consisted of e-mailing 500 Oral Surgeons with a valid e-mail address published in the American Association of Oral and Maxillofacial Surgeons (AAOMS) directory. Since the response rate was less than 50% we sent out another e-mail to 500 Oral Surgeons.   Up to 1000 surgeons were contacted. There was no bias in subject selection since the emails address were randomly selected by a person not involved in the study. Qualtrics (Survey tool of Tufts University) was used to facilitate the distribution and completion of surveys. A total of 110 oral surgeons responded to the survey.  94% of responders were male. 82% of the responders were in private practice and them only 37% reported using checklist in their practice. 60% of participants (n=66) reported that they were not using a surgical safety checklist for ambulatory surgery. 93% of the participants reported that if provided they would consider implementing a surgical safety checklist in their practice. 26% of Oral Surgeons reported that they were not using a safety checklist in their practice although they reported that they were performing more than 30 procedures a week. Although not statistically significant, the majority of the oral surgeons who had completed OMFS training for longer than 20 years reported not using a checklist in their practice. According to our survey, the majority of practicing oral and maxillofacial surgeons do not currently use surgical safety checklists. Although the response rate was 12%, the survey does reflect a clear lack of use of checklists among practicing oral and maxillofacial surgeons despite the widespread acceptance in the medical community.

References:

1. Haynes et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360:491-9