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Surgical Checklists - Improving Patient Safety

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Surgical Check Lists – How LLEP is using research from human medicine to improve the quality of care being delivered and as an essential tool in patient safety. 

Check lists originated in the aviation industry and in 2008 the World Health Organisation introduced a safety checklist for surgery. Surgical check lists have since been shown to reduce death rates and significantly improving inpatient complications. 

So how does this translate to veterinary medicine? Basically it helps us avoid making critical errors by missing crucial steps. Equine surgery is a high-pressured environment and horses are generally not designed very well when it comes to general anaesthetics. We have been using surgical checklists at LLEP for the last five years and believe they have played a crucial role in improving patient outcomes. 

So what’s involved? Before each surgery the team will confirm the identification of the horse and the procedure and site of surgery.  Consent is double-checked and if the patient has been referred in to us by another practice, a check is made that the vet has been contacted. Other checks pre surgery include whether the horse has had pre-meds, if it is vaccinated against tetanus or had antitoxin and if there are any known allergies. Pre-anaesthetic checks such as shoes removed, mouth washed out and pre surgery blood results are all checked before the team test all of the surgical equipment. Finally anticipated complications are discussed with the whole team. 

After surgery the team will discuss primary concerns and post operative medication. The equipment will all be checked and any repairs required will be noted and a swab count is undertaken. Finally the team check that we have made that all important phone call to the owner to let them know that their horse is safely back on their feet.