Patient Safety in the Operating Theatre: Implementation of a Surgical Safety Checklist in Mutengene, Cameroon

Elizabeth Embick, 4th Year Medical Student, University of Washington; Henry Ndasi, MD, Chief of Surgery, Baptist Hospital Mutengene, Cameroon

Purpose: Surgical morbidity and mortality are major global health issues.  Over 7 million surgical complications occur each year, many of which are preventable.  Implementing a surgical checklist has been shown to reduce perioperative mortality by 50% and reduce the rate of complications by 30%.  There was no checklist in place at Baptist Hospital Mutengene (BHM) , a growing medical facility in Southwest Region, Cameroon with a new surgical department. 

Methods:  Using evidence based standards and collaborating with local staff, an individualized surgical safety checklist was created and implemented to improve patient outcomes.  The checklist was based on WHO Guidelines, observation of existing work flow, and discussion with local staff.  Training was given to physicians and OR nursing staff on the research supporting surgical checklist use, implementation, and the process of quality improvement.  Hardcopies of the checklist were posted in the operating room and a digital version was given to providers for future use.

Results:  A checklist that had been adapted to local context was implemented in the OR with full support of the surgical staff.  The nurse anesthetists assumed responsibility for conducting the checklist and use of the checklist during every major surgical case was observed for 7 days.  Follow up evaluation indicated that use of the checklist continued for all 20-30 major cases per week. 

Conclusions: This project met its goals of improving patient safety in a new surgical department in a collaborative, sustainable manner.  The process of creating and implementing the project encouraged communication and collaboration between staff.  Additional efforts are warranted to promote the continued use of the surgical safety checklist at BHM, to expand its use to other hospitals in the Cameroon, and to continue to implement evidence-based quality improvement measures globally.  

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