Making Surgical Care Safer: A Survey on the Implementation of the Checklist by Belgian Surgeons.

BACKGROUND: The operating theatre (OT) is a complex environment. The purpose of this survey was to evaluate the implementation of the surgical checklist (SC) at individual level by Belgian Surgeons.

METHODS: A Surgical Checklist Questionnaire (SCQ) related to the use of the SC by individual surgeons was attached to the registration website for the 2015 Belgian Surgical Week. It was a one page long, user friendly document, easy to be filled voluntarily and anonymously.

RESULTS: Among the 206 surgeons who registered, 81 (39%) filled in the SCQ. The SC template proposed by the WHO "Safe Surgery Saves Lives" initiative was used by 91% of the respondents. However, 89% adapted the SC to their local hospital environment, and 87.5% use it personally for their patients. Since implementation, the SC was never adapted in 46%. According to 21% of respondents, an adverse event was avoided thanks to the SC. Amazingly, SC was considered as an administrative burden by 83% despite the same percentage recognized that patients benefited from the SC. Only 28% of respondents got feedback from the use of the SC.

CONCLUSIONS: In this survey, the number of adverse event avoided thanks to the use of the SC demonstrates that SC -represents a simple strategy for addressing surgical patient safety in OT. Nevertheless, SC is still considered by many surgeons as an additional administrative burden and/or as just another gimmick. Further studies are needed to understand why some surgeons are still not willing to adapt to a changing safety culture.