Reducing peri-operative harm

Performing safe surgery relies on the ability of surgical team members to combine professional knowledge and technical expertise with non-technical skills (e.g. communication, teamwork, situational awareness, leadership and decision-making). Research shows communication and teamwork failure is at the core of nearly every medical error and adverse event, including surgical events.


Since February 2014, the Waikato Hospital main operating theatre team have been participating in a Proof of Concept’ project supported by the Health Quality and Safety Commission(external link) to ensure the World Health Organization (WHO) surgical checklist and team briefings are consistently undertaken. This was firstly as part of the national working group to plan and develop a toolkit of resources and concepts, and secondly as the trial hospital alongside Lakes District Health Board and Southern Cross Hospital in Auckland.

Some of the tools were already in use at Waikato DHB and consisted of:

  • a team briefing at the beginning of the day where all the surgical team meet and discuss in detail the cases for the day
  • a surgical safety checklist which consists of three parts, to ensure all safety checks have been made about each patient throughout the surgical procedure
  • a team discussion at the end of the day to reflect on what went well or what could we improve

A report is currently being compiled by the national project team which will help to inform the Health Quality and Safety Commission how best to use the concepts on a national basis in 2015. The staff have contributed valuable feedback from their daily use of the tools and concepts to help inform this report.

The trial itself finished on 30 November 2014, but the improvements gained over this time are being sustained. 
These include

  • better communication within the teams
  • team briefings occurring on a consistent basis
  • improved results in the surgical safety checklist audit results. 

This will greatly improve the experience for our patients, and ensure a safe journey while in our care.

* The term "peri-operative" refers to the three main phases of surgery: pre-surgery, the surgery itself, and post-surgery.