Dr. Sabatino Bianco(Vernon Bryant/Staff Photographer)
“Girls, do you have everything you need?” asks nurse Sunny Austin.
She’s asking scrub tech Ania Jackson and fellow nurse Karen Brittain whether the wide variety of possible tools and supplies needed for the upcoming surgery are on hand.
Austin had already gotten verbal confirmation from five other doctors, nurses and techs that they have done specific tasks and have specific supplies before they opened the incisions of their patient.
The results are logged into Texas Health Arlington Memorial Hospital’s electronic health records. Austin’s banter right now is intended to show photographer Vernon Bryant and me, who’ve just entered the OR, how the hospital’s “checklist” works.
Patients here are among the least likely in Texas to die if they suffer the kind of serious, treatable complications that sometimes follow surgery. In fact, a story in tomorrow’s paper will show that Arlington Memorial outdid every other North Texas hospital at avoiding those deaths.
I’ve been looking at safety data on the 100 busiest Texas hospitals since last fall, and late Thursday night we posted this database of our findings. Sunday’s story will outline what we found.
Which brings us back to Austin and the surgical team.
In large letters on the wall, on a laminated sheet in Austin’s hand and on the computer screen in front of her are a series of questions she and colleagues go through verbally before and during every surgery.
Given the highly trained professionals on hand, including neurosurgeon Dr. Sabatino Bianco, the specifics seem awfully specific:
- Has everyone introduced themselves?
- Can you each tell me the name and birthday of the patient, the procedure you’re doing and its location?
- How many sponges did you use and are they accounted for?
But their surgical checklist is based on a standard developed for the World Health Organization. And part of that standard is to make the operating room a place where everyone feels comfortable speaking up. Even Austin’s friendly tone is part of the plan.
The systematic, repeatable use of the steps outlined in the checklist every time, for every surgery has been shown to reduce errors, infections and complications. The Texas Health chain is part of a national study on using the checklist at U.S. hospitals.
So, at this community hospital in a middle income community — not as fancy as many of the big city medical centers — the doctors, nurses, technicians and administrators have done something right.
How much of that performance is due to the checklist and how much to other factors? I don’t know. But it’s probably not a coincidence.