Authors (including presenting author) :
Lam I. (1)(2), Kwong P.S. (1)(2), Ng L.K. (1)(2)
Affiliation :
(1) Ruttonjee Hospital (2) Operating Theatre
Introduction :
Adverse medical events that involve patients who have undergone an operation of the wrong body part, experienced an incident procedure are striking and frightening for all parties involved. We have experience the near miss incident that in which all patients’ document were recorded the wrong operative side. On the other hand, there is recommendation from ACHSI Organization Wide Survey (OWS) 2017 that we needed to engage patients in identification process. Patients are encouraged to participate in self- advocacy including the patient in verification process whenever possible. We believe that Patient engagement is an important strategy to improve both the safety and quality of care.
Objectives :
-To ensure correct operative site procedure
-To optimize peri-operative patient engagement
Methodology :
1. Design a form for patient to circle the operation site on the form by themselves at receiving area of OT
2. From March 2018 which included all elective schedule orthopedics and surgical patients those were conscious and communicable person, without any cognitive impairment.
Result & Outcome :
We had done the pilot study since March 2018 on 50 cases. 24 cases were Surgical and 26 were Orthopaedic. No patient refused and the whole project ran smoothly. Then, we decided to keep going the project and including emergency patients. Up to March 2019, total 1315 cases were done. For Orthopaedic procedures: there are around 95% general anesthesia patients, and 94% local anesthesia patients need to define operative site. For the Surgical procedures, there are around 46% GA cases and 71% LA cases required defining operative site. Patient age is ranged from 14 to 92 years old. All patients can circle the correct operative site within 1 min. No patient refuse to participate in the project and they all can circle the correct operative site. Lastly, ‘Smart Chart ‘was approved as a formal hospital document. ‘Smart check’ can strengthen the alertness of checking the correct operative site. It can ehance patient safety and optimize patient engagement.