Start Using the Checklists
With all your implementation steps complete, you’re now ready to use the checklists. You need a strategy to make sure OR staff can easily access the emergency checklists in a crisis.
Take a phased approach
Teams in smaller facilities may be able to begin using the emergency checklists in all of the ORs at once. However, in larger facilities, we encourage teams to begin using emergency checklists in phases. For example, start using emergency checklists with a limited group of operating rooms, perhaps within one surgical subspecialty. This makes training more manageable, and allows more time to refine or “de-bug” the checklists and training techniques. Once these learnings are captured, move on to another group. As each OR group becomes comfortable with the checklists, the number of advocates and coaches for their use grows. In highly specialized OR units, consider customized versions. For example, you can include a checklist for critical events related to cardiopulmonary bypass for the cardiac service or a checklist for management of spinal cord ischemia in the neurosurgery or orthopedic areas.
Consistently encourage checklist use
Promoting and maintaining awareness of the emergency checklists is an over-arching goal of implementation. If your facility utilizes a standard time-out or checklist on routine cases, consider including a prompt that verifies availability of the checklist and calls on a team member to point out its location at the beginning of the day or at the start of each case. See discussion of further production and accessibility options, pros and cons at Stanford’s Emergency Manual website (in the implementation tips).
Next step: Monitor Use