3 thoughts on “Problem Memo: New Procedure/Method for Conducting Safety Checks in the OR”
Maria, you were able to convey the seriousness of this issue, but it did not reveal itself until the middle of your memo. Providing the frightening statistics, “from January 1, 2010 to December 31, 2013 the Joint Commission sentinel event database shows that there were “463 incidents of wrong patient, wrong site and wrong procedure surgeries” (p. 4).” earlier in the memo would have been beneficial. Another part of the memo that honed in the importance of this issue was the finding that “… 48% of all surgical complications are preventable”.
As a healthcare worker myself, I can easily see the importance of safety checks. The OR is another world for me, but these checklists are similar to what I used in the military on my flights. Whether it was training or real world, those checklists were open to the correct stage and each step was read verbatim.
Hi Susan,
Thank you for reading my memorandum and for the feedback. I agree perhaps I should have placed the problem statement in the beginning. I will definitely remember that suggestion for the future. Thanks again, Maria
Hi Maria, I like the feedback that Susan left and I believe that feedback will help to make this memorandum stronger. I would like to work with you on this project; I think we can combine efforts to improve safety in the operating room. My memorandum involved policy and practice matching. We could combine because there are policies regarding Universal Protocol in the operating room; so, ensuring those policies on safety checklists are followed is key. You did a great job showing that agencies and NY require these safety checklists but errors continue to occur. So, how can a hospital roll out a new procedure to ensure compliance? I found the quote you including in your summary paragraph compelling. Even with these policies and requirements, human error continues to occur. Susan had a wonderful analogy above with her military flights. If you would like to work together, perhaps we could include research regarding the effectiveness of standardization and the need to be “present” in each moment with our patients. Thank you.
Maria, you were able to convey the seriousness of this issue, but it did not reveal itself until the middle of your memo. Providing the frightening statistics, “from January 1, 2010 to December 31, 2013 the Joint Commission sentinel event database shows that there were “463 incidents of wrong patient, wrong site and wrong procedure surgeries” (p. 4).” earlier in the memo would have been beneficial. Another part of the memo that honed in the importance of this issue was the finding that “… 48% of all surgical complications are preventable”.
As a healthcare worker myself, I can easily see the importance of safety checks. The OR is another world for me, but these checklists are similar to what I used in the military on my flights. Whether it was training or real world, those checklists were open to the correct stage and each step was read verbatim.
Hi Susan,
Thank you for reading my memorandum and for the feedback. I agree perhaps I should have placed the problem statement in the beginning. I will definitely remember that suggestion for the future. Thanks again, Maria
Hi Maria, I like the feedback that Susan left and I believe that feedback will help to make this memorandum stronger. I would like to work with you on this project; I think we can combine efforts to improve safety in the operating room. My memorandum involved policy and practice matching. We could combine because there are policies regarding Universal Protocol in the operating room; so, ensuring those policies on safety checklists are followed is key. You did a great job showing that agencies and NY require these safety checklists but errors continue to occur. So, how can a hospital roll out a new procedure to ensure compliance? I found the quote you including in your summary paragraph compelling. Even with these policies and requirements, human error continues to occur. Susan had a wonderful analogy above with her military flights. If you would like to work together, perhaps we could include research regarding the effectiveness of standardization and the need to be “present” in each moment with our patients. Thank you.