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Using Standardized Checklists Increase the Completion Rate of Critical Actions in an Evacuation from the Operating Room: A Randomized Controlled Simulation Study

Published online by Cambridge University Press:  07 August 2019

Yahya A. Acar Open the ORCID record for Yahya A. Acar [Opens in a new window] ,
Neil Mehta ,
Mary-Ann Rich ,
Banu Karakus Yilmaz ,
Matthew Careskey ,
Jose Generoso ,
Richard Fidler  and
Jan Hirsch
Yahya A. Acar*
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA Department of Emergency Medicine, Health Sciences University, Gulhane Medical Faculty, Etlik, Ankara, Turkey
Neil Mehta
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA
Mary-Ann Rich
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA
Banu Karakus Yilmaz
Affiliation:
Sisli Hamidiye Etfal Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
Matthew Careskey
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA
Jose Generoso
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA Universidade Santo Amaro, Instituto Prevent Senior, Medcel, Brasil
Richard Fidler
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA
Jan Hirsch
Affiliation:
Department of Anesthesia and Perioperative Care, San Francisco Veterans’ Affairs Medical Center, University of California San Francisco (UCSF), San Francisco, CaliforniaUSA
*
Correspondence: Yahya A. Acar, MD Department of Emergency Medicine Health Sciences University Gulhane Medical Faculty General Tevfik Saglam Street 06010 Etlik, Ankara, Turkey E-mail: yahyaacar@gmail.com
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Abstract

Introduction:

Hospital evacuations of patients with special needs are extremely challenging, and it is difficult to train hospital workers for this rare event.

Hypothesis/Problem:

Researchers developed an in-situ simulation study investigating the effect of standardized checklists on the evacuation of a patient under general anesthesia from the operating room (OR) and hypothesized that checklists would improve the completion rate of critical actions and decrease evacuation time.

Methods:

A vertical evacuation of the high-fidelity manikin (SimMan3G; Laerdal Inc.; Norway) was performed and participants were asked to lead the team and evacuate the manikin to the ground floor after a mock fire alarm. Participants were randomized to two groups: one was given an evacuation checklist (checklist group [CG]) and the other was not (non-checklist group [NCG]). A total of 19 scenarios were run with 28 participants.

Results:

Mean scenario time, preparation phase of evacuation, and time to transport the manikin down the stairs did not differ significantly between groups (P = .369, .462, and .935, respectively). The CG group showed significantly better performance of critical actions, including securing the airway, taking additional drug supplies, and taking additional equipment supplies (P = .047, .001, and .001, respectively). In the post-evacuation surveys, 27 out of 28 participants agreed that checklists would improve the evacuation process in a real event.

Conclusion:

Standardized checklists increase the completion rate of pre-defined critical actions in evacuations out of the OR, which likely improves patient safety. Checklist use did not have a significant effect on total evacuation time.

Keywords

disaster planningsimulation trainingtransportation of patients
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 4 , August 2019 , pp. 393 - 400
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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