Martinsburg VA Medical Center Upgrades Patient Safety With Checklist Boards
The Martinsburg VAMC Patient Safety Officer recognized the potential for a problem. “We were concerned about a potential patient safety issue,” said PSO Kent Wagoner. “There wasn't a consistent process for performing a pre-procedure time-out. Our Checklists in use consisted of a variety of methods and inconsistent content. In addition, then VA wanted to be in compliance with the directives 2010-023 and VHA 1039
PSO Wagoner contacted Checklist Board President, Rick Taylor, to upgrade their existing Checklist protocols. The Martinsburg VAMC team had a clear vision of what they wanted to include on their custom designed Checklist Boards. Collaborating with the Checklist Boards team and incorporating content from other checklists, a consistent content and format was developed that could be used throughout the Martinsburg VAMC across several procedural areas. Checklist boards were developed and deployed in the OR, pre-procedure, Endoscopy, ED and other areas.
Now after full implementation, a new culture of patient safety is developing. Comments from the Martinsburg VA staff included: “I can’t imagine not using them.”
As surgical Time-Outs and Checklist Boards become routine for all invasive procedures, the instance of Never Events should decrease and the improvement in patient and staff satisfaction should increase.