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NZ surgical safety culture continues to improve

Safe Surgery NZ
10 September 2019

A third national survey of district health board (DHB) surgical staff shows that in most instances people work together as a well-coordinated team.

The survey was undertaken by the Health Quality & Safety Commission’s Safe Surgery NZ programme. Since 2012, the Commission has had a goal of reducing surgical harm. Research suggests teamwork and communication failures are at the core of many medical errors and adverse events.

The Safe Surgery NZ programme promotes national use of surgical safety checklists to improve team work and improve safety. The checklists, developed by the World Health Organization, are a guide for making sure the correct surgical procedures are carried out on the correct patient. All public and some private hospitals are implementing surgical safety checklists in their operating theatre as part of the programme.

The programme also promotes other communication tools such as a briefing at the start and end of the theatre list. Over 60 surgical teams across New Zealand participated in a recent promotional campaign to encourage teams to ‘Spend five to save lives’ by undertaking start-of-list briefings.

The third surgical safety culture survey assessed the current state of safety culture and changes over time. More than 800 people responded to the survey and the results for 2019 have continued the encouraging progress seen in the 2015 and 2017 surveys.

Statistically significant improvements since the first survey in 2015 include:

  • 30 percent increase in participants saying team discussions (briefings and debriefings) are common
  • 20 percent increase in surgical teams always discussing the operative plan
  • 14 percent increase in surgical team members from different disciplines always discussing patients’ conditions and progress.

Participants also highlighted where there is room for improvement. Key issues include some DHBs not yet doing briefings and debriefings at the start and finish of each theatre list and inconsistency in attitudes of some surgical staff with respect to their buy-in to the surgical safety checklist.

The findings underline the benefit the Safe Surgery NZ programme’s continuing focus on use of checklists and implementing briefings and debriefings more widely.

 The full report can be read below.

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