Kelly Gordon

Vets for Pets Cambridge, Cambridge, United Kingdom

Objectives

This quality improvement project was conducted at a large, small animal, first-opinion and referral hospital performing 10–20 procedures daily. It was initiated following near-miss incidents identified through internal reporting.

 The aim of the project was to improve completion rates of pre-procedure safety checklists from 40% to 90% within 5 months.

Methods

We utilised the Institute for Healthcare Improvement Model for Improvement framework, setting a clear aim and measurements and using iterative change cycles - Plan, Do, Study Act (PDSA)

An initial data set was collected to establish a baseline measure. Then small amounts of data was collected within each PDSA cycle to measure response to change as the project progressed.

 The chosen measure was the number of steps of the pre-procedure safety checklist being completed. Day procedures requiring sedation or anaesthesia were included, out of hours and emergency procedures were excluded.

Results

A visual change to the anaesthetic chart was introduced and refined during the PDSA cycles. The run chart data demonstrated a statistically significant change with 32 data points above the median line.

Implementing 6 PDSA cycles, a significant change to the baseline data was demonstrated. Resulting in a sustained checklist completion rate of 100%, meeting and exceeding the project aim.

Statement: Impact/ Clinical Significance

This project demonstrated that a system change can have a significant impact on safety checklist compliance, improving patient safety and also helping to reduce the negative impact that safety incidents can have on colleague mental health and wellbeing.