An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams. (October 2015)

• Record Type: Journal Article
• Authors: Tscholl, David W.; Weiss, Mona; Kolbe, Michaela; Staender, Sven; Seifert, Burkhardt; Landert, Daniel; Grande, Bastian; Spahn, Donat R.; Noethiger, Christoph B.
• Is Part Of: Anesthesia & analgesia. Volume 121:Number 4(2015)
• Publication Date: 2015-10
• Subjects: Anesthesiology -- Periodicals; Anesthesia; Anesthesiology; Analgesia; Analgesics; Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1213/ANE.0000000000000671
• Languages: English
• ISSNs: 0003-2999

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>BACKGROUND:</title> <p>An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked).</p> </sec> <sec> <title>METHODS:</title> <p>A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork.</p> </sec> <sec> <title>RESULTS:</title> <p>One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (<italic>P</italic> < 0.001), knowledge of critical information: 100% vs 90% (<italic>P</italic> < 0.001), perception of safety: 91% vs 84% (<italic>P</italic> < 0.001), perception of teamwork: 90% vs 86% (<italic>P</italic> = 0.028), and clinical performance: 93% vs 93% (<italic>P</italic> = 0.60).</p> </sec> <sec> <title>CONCLUSIONS:</title> <p>This study provides empirical evidence that the use of a preinduction checklist significantly improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams—all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork.</p> </sec> </abstract>