Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/93713
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Type: Journal article
Title: Multi-institutional evaluation of a sinus surgery checklist
Author: Soler, Z.
Poetker, D.
Rudmik, L.
Psaltis, A.
Clinger, J.
Mace, J.
Smith, T.
Citation: The Laryngoscope, 2012; 122(10):2132-2136
Publisher: Wiley
Issue Date: 2012
ISSN: 0023-852X
1531-4995
Statement of
Responsibility: 
Zachary M. Soler, David A. Poetker, Luke Rudmik, Alkis J. Psaltis, John D. Clinger, Jess C. Mace and Timothy L. Smith
Abstract: Objectives/Hypothesis: To examine the frequency of safe surgical practices specific to endoscopic sinus surgery (ESS) before and after implementation of a checklist at four institutions across North America. Study Design: Prospective, multi-institutional, observational study. Methods: Consecutive surgeries were observed at four institutions before (n = 100) and after (n = 100) implementation of the ESS Checklist. A passive observer documented whether 10 specific tasks were performed by the surgical team during the course of each case. The frequency with which each item was performed was tabulated, and differences across institutions were evaluated using the Pearson χ2 test. Improvement in the frequency of each single item between pre- and postintervention time periods was assessed by the McNemar χ2 test. Results: Successful performance of all 10 tasks in the prechecklist period was not observed for any ESS case at any of the four study sites. As might be expected, performance of any individual task was highly variable, ranging from 14% to 95%. After implementation of the ESS Checklist, successful performance of all 10 tasks during an individual surgery increased from 0% to 87% across all institutions, a change that was highly significant (P < .001). Significant increases in the performance of individual tasks was observed for nine of 10 items across all institutions (P ≤ .031 for all). Conclusions: Significant heterogeneity exists with regard to performance of specific tasks aimed at minimizing error during ESS. Utilization of the ESS Checklist standardized practice across four institutions and significantly increased the likelihood that individual safety tasks were performed during the course of sinus surgery.
Keywords: Checklist; sinusitis; medical errors; operating rooms; safety; health care evaluation mechanisms; Level of Evidence: 2C
Rights: © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
DOI: 10.1002/lary.23437
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