Get Buy-In

It’s critical to gain support from everyone in a facility who will play a role in implementing and using the checklist. Informal one-on-one conversations and presentations at department meetings are effective ways to get buy-in.

In stressful and uncommon emergencies, memory can fail – using cognitive aids like emergency checklists has been shown to help.

Engage clinical and administrative leadership first

Getting buy-in to use emergency checklists is a critical component of their successful adoption and meaningful, consistent use. Without the support of your administrative and clinical leaders early on, your teams will be less likely to try or regularly use emergency checklists during OR crises. Getting buy-in from administrative leaders also encourages them to supply resources for the production of materials and to grant time for training and simulation.

When introducing change, early communication and outreach is vital

Emergency checklists may be a new way to manage emergencies within your institution. Changing longstanding habits and processes may be challenging, so it is important that all surgical team members understand the reason for using emergency checklists. The earlier perioperative disciplines are included, the more likely they will be to accept these changes as involved players, remember to use the checklist, volunteer to read it when needed, and embrace its value.

Clarify why emergency checklists are important for your institution

Take the time to review the data reports available for past unexpected events that have occurred within the OR over the past few months. Review the current methods and protocols available for managing OR crises. Think about what is working and what is not. Identify specific opportunities where the emergency checklists would help improve the current management of these events. Understanding what the checklists will help improve within your institution will be extremely important when explaining why you are beginning this endeavor.

Understand the players and the landscape, and seek multi-disciplinary support

It’s very helpful to approach key hospital leaders as a multidisciplinary implementation team, and be clear that a full perioperative team is committed to and driving the implementation. The key hospital leaders who can be valuable supporters include:

  • Directors of perioperative services
  • Risk managers
  • Chief medical or quality officers
  • Chiefs of surgery and anesthesia
  • Nurse managers
  • Pharmacists
  • Individual surgical practices
  • Board of trustees

Present at department meetings and joint conferences

Department or joint conferences are efficient settings to get the word out to staff. Use this time to show them the emergency checklists and talk them through the ways in which they will improve management of OR crises.

Meet individually with key or potentially resistant thought leaders

Are there individuals who you expect will resist and/or undermine the implementation? Invest the time to have 1-on-1 conversations with them to discuss the emergency checklists. A well-planned and rehearsed conversation with a respected peer can be an opportunity to answer questions, dispel resistance, and generate support. These conversations may take the form of scheduled meetings, lunchtime conversations or even a beer after work.

When introducing the checklists to your colleagues, follow the old aphorism, “over-communicate and then communicate some more.”

Think of getting buy-in as a marketing campaign

Successful implementation have employed some of the marketing-like tactics below in reaching the right people in multiple ways:

  • Announcements and invitations for further discussion at faculty meetings or at departmental conferences
  • Email updates on emergency checklist implementation
  • Bulletin board posters with photos of trainings or simulations, or lists of FAQs
  • Making or showing video demonstrations of emergency checklist use
  • Promotional materials such as buttons or stickers
  • Sharing individual staff testimonials
  • Placing flyers inside doors of toilet stalls (!)
  • Computer screen-saver messages

Tapping your facility’s public relations or marketing professionals for the project can uncover additional opportunities to spread the word.

Next Step: Create a Multidisciplinary Team