Episode 22: Safe Surgery Checklist in Alberta

In this episode Dr Marcia Clark introduces the Safe Surgery Checklist, which is mandatory for all surgical procedures in Alberta. Marcia presents the background of the Safe Surgery Checklist, beginning with a project by the World Health Organization, Safe Surgery Saves Lives. To help accommodate the complexity in health care today, medical providers work in teams that can include surgeons, nurses, anesthetists, social workers, nutritionists, physical therapists, pharmacists and others. Checklists were introduced to deal with this complexity by improving steps in processes, promoting communication and establishing a baseline of performance.

Marcia covers each point of the Safe Surgery Checklist approved for use in Alberta, then walks us through its use in her own operating room. Finally, she considers the use of a checklist in other areas of health care, such as obstetrics, endoscopy and interventional radiology, and consults with colleagues on its possible implementation in respective areas.

After listening to this podcast listeners will be able to:
1.  Understand the history of the Safe Surgery Checklist
2.  Know the three phases of the Safe Surgery Checklist – Before Induction of Anesthesia, Before Skin Incision, and Before Patient Leaves Operating Room – and be                           familiar with the items covered in each phase
3.  Consider other applications of the checklist in procedurally based areas outside of surgery

Marcia Clark, MD
Marcia is an Orthopaedic Surgeon at the South Health Campus in Calgary, Alberta. She is Director of Surgical Foundations, Clinical Associate Professor in the Department of Surgery at the University of Calgary. She completed her undergraduate degree at the University of New Mexico (Albuquerque) and her medical degree at the University of Calgary, followed by Orthopaedic Residency training at the University of Alberta. Marcia completed two Fellowships. Firstly, a Hip and Knee Reconstruction Fellowship, at the Wakefield Clinic and University of Adelaide in Adelaide, South Australia. Her second Fellowship was at the University of Calgary in Surgical Education and Revision Joint Arthroplasty, where she earned a Master of Science in Medical Education. Marcia’s clinical interests involve complex primary and revision hip and knee surgeries. Additionally, she is an active member of the Canadian Alpine Ski Team Medical group, providing care for athletes and support staff at National and International level. She also in involved in the Indy and Formula 1 international motor sports events providing medical care. She recently earned her Diploma in Sports and Exercise Medicine. Academically, her area of expertise is in curriculum design and evaluation and a special interest in the use of simulation in medical education, specifically around non-technical skills. She has an active role in post-graduate surgical education assisting in curricular change of the Surgical Foundations program at local and national levels. Marcia has an Advisory role with the Royal College of Physicians and Surgeons of Canada in the CanMEDS 2015 project, the Simulation Educators Course and is a member of the new CanMEDS Academy of Educators.

References:
Alberta’s mandatory Safe Surgery Checklist
Atul Gawande’s “The Checklist Manifesto”
Newkirk, J.D. (2013). Preventing surgical mishaps: using surgical checklist. Clin Plast Surg, 40(3), 475-87.
Berenholtz, S.M., Lubomski L.H., Weeks K., Goeschel C.A., Marsteller J.A., Pham J.C., et al. (2014). Eliminating central line-associated bloodstream infections: a national patient safety imperative. Infect Control Hosp Epidemiol, 35(1), 56-62.