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CUSP & NSQIP – how they connect
Why join CUSP
Sep/12
RCH
joins
CUSP
Pilot
Project
Dec/14
PAH
In-Patient
Unit,
ERH join
CUSP
Nov/13
RCH
new
CUSP
Apr/14
CUSP
Kick-
off
May/14
PAH
OR
CUSP,
ARH
CUSP
Jun/1
4
RMH
July/14
BH
2
1) How we can cause harm to the next patient?
2) How we can prevent harm to the next patient?
Purpose
Who completes it
3
Establishing common ground in a complex
system
o Large OR/PACU
o Multiple specialties
o Complex patients
o Sophisticated surgeries
Insert a graphic,
possibly of a complex
system or a spaghetti
diagram?
6
Holding bins in the OR
o Keep it clean
Scary signs
o Prevent scrubs being taken
by non-OR staff
Normothermia study
o Are we keeping them warm
enough? YES!
Insert graphic
– surgical thongg?
8
How do we make the Surgical Checklist
shorter ?
streamlined ?
relevant ?
It had to be BRIEF
The surgical brief
9
• T – This our patient? Identifiers,
Consent, Imaging, History, Meds
• H – High Risk Attributes? ASA,
Allergies, Difficult Airways, VTE, Anticipated Blood
Loss, Prophylaxis
• O – Overview Procedure, Site, Side, Critical
Steps
• N – Nursing Concerns Equipment,
Positioning, Staffing
• G – Gas Passer (Anaesthesia)
Review Airway or IV access issues, critical
resuscitation plans, redosing Abx
• G – Got Issues? Final pre-incisional check 10
Smaller site
Comfortable in practice
Why change?
Need more information
2 question survey provided the mechanism
11
Excessive traffic in and out of the OR
Sterile wrappers prone to tearing
Complacency
with pre op
checklist
Checking
cataract
lenses
12
‘Great Catches’ celebrated
Communication improvement within
and with outside units
Best practices being
followed
Re-focused the team
on the patient
13
Survey as catalyst
◦ Process change
◦ Behaviour change
◦ Communications
◦ Teamwork
◦ Better workplace for staff
◦ Surgeons, Anesthesiologists feel
they have a greater voice
◦ Improved patient outcomes
14