Implementation of the surgical safety checklist in Switzerland and perceptions of its benefits: cross-sectional survey

OBJECTIVES: To examine the implementation of the Surgical Safety Checklist (SSC) among surgeons and anaesthetists working in Swiss hospitals and clinics and their perceptions of the SSC. METHODS: Cross-sectional survey at the 97th Annual Meeting of the Swiss Society of Surgery, Switzerland, 2010. Opinions of the SSC were assessed with a 6-item questionnaire. RESULTS: 152 respondents answered the questionnaire (participation rate 35.1%). 64.7% respondents acknowledged having a checklist in their hospital or their clinic. Median implementation year was 2009. More than 8 out of 10 respondents reported their team applied the Sign In and the Time Out very often or quasi systematically, whereas almost half of respondents acknowledged the Sign Out was applied never or rarely. The majority of respondents agreed that the checklist improves safety and team communication, and helps to develop a safety culture. However, they were less supportive about the opinion that the checklist facilitates teamwork and eliminates social hierarchy between caregivers. CONCLUSIONS: This survey indicates that the SSC has been largely implemented in many Swiss hospitals and clinics. Both surgeons and anaesthetists perceived the SSC as a valuable tool in improving intraoperative patient safety and communication among health care professionals, with lesser importance in facilitating teamwork (and eliminating hierarchical categories)

Is team-based perception of safety in the operating room associated with self-reported wrong-site surgery? An exploratory cross-sectional survey among physicians

Aims: Participation in wrong‐site surgery may negatively influence the perception of safety by the health care professionals in the operating room (OR). The objective was to explore if perception of safety in the OR was seen as a team‐based or individualist concern and whether having participated in wrong‐site surgery was associated with perception of safety. Method and Results: Cross‐sectional survey at 2 annual meetings of surgery, in Switzerland, 2010. We used multivariate generalized models to assess the association of perception of safety in the OR (1 item) with self‐reported participation in wrongsite surgery—overall, past (more than 3 y ago), or recent (last 3 y) participations—controlling for sociodemographic characteristics and opinion of the surgical safety checklist. One hundred ninety respondents answered the questionnaire (participation rate of 22.6%). Respondents mostly had a team‐based, rather than an individualistic, perception of safety in the OR. In multivariate analyses, the influence of ever participation in wrong‐site surgery was not significant. However, past participation in wrong‐site surgery (more than 3 y ago) was associated with perception of safety as team based, whereas recent participation (last 3 y) was associated—despite not significant at α ≤ 5%—with perception of safety as individualistic. Conclusion: In this sample, safety in the OR is most often seen as team based rather than individualistic. Perceiving safety in the OR as team based varies according to recent or past participation in wrong‐site surgery. Longitudinal research is needed to assess causality between participation in wrong‐site surgery and change in perception of safety

Institutional support to the implementation of the Surgical Safety Checklist (Switzerland, 2010).

<p>* No support  =  1, Little support  = 2, Medium support = 3, Strong support = 4, Very strong support = 5.</p

Attitudes toward the Surgical Safety Checklist (Switzerland, 2010).

<p>*Don't agree at all = 1, Don't agree = 2, Partially agree = 3, Agree = 4, Fully agree = 5.</p

Attitudes towards the SSC among respondents working in hospitals with or without the SSC and those working in the public or private sector (Switzerland, 2010).

<p>* Chi-square test or Fisher exact test if at least one cell had a frequency of 10 or less.</p

Characteristics of participating physicians (N = 152).

a<p>Total of percentage exceed 100% due to surrounding.</p

Content of the Surgical Safety Checklist (SSC) implemented in the hospital's respondent and perceived compliance rate to the SSC (Switzerland, 2010).

a<p>“Please indicate if these checklist sections are applied either never, rarely, partially, very often, or quasi systematically within <i>your surgical/anaesthetic team</i> (i.e., the one with which you operate most often)”.</p><p>* Never = 1, Rarely = 2, Partially = 3, Very often = 4, Quasi systematically = 5.</p

Magnetic polarons and the metal-semiconductor transitions in (

We present inelastic light scattering measurements of EuO and Eu$_{1-x}$La$_{x}$B$_6$ ($x$=0, 0.005, 0.01, 0.03, and 0.05) as functions of doping, B isotope, magnetic field, and temperature. Our results reveal a variety of distinct regimes as a function of decreasing T: (a) a paramagnetic semimetal regime, which is characterized by a collision-dominated electronic scattering response whose scattering rate $\Gamma$ decreases with decreasing temperature; (b) a spin-disorder scattering regime, which is characterized by a collision-dominated electronic scattering response whose scattering rate $\Gamma$ scales with the magnetic susceptibility; (c) a magnetic polaron (MP) regime, in which the development of an $H$=0 spin-flip Raman response betrays the formation of magnetic polarons in a narrow temperature range above the Curie temperature T$_{\rm C}$; and (d) a ferromagnetic metal regime, characterized by a flat electronic continuum response typical of other strongly correlated metals. By exploring the behavior of the Raman responses in these various regimes in response to changing external parameters, we are able to investigate the evolution of charge and spin degrees of freedom through various transitions in these materials.Comment: 19 pages, 13 figures on 5 pages (Gif format