Development and content validation of a surgical safety checklist for operating theatres that use robotic technology
- To identify and assess potential hazards in robot-assisted urological surgery.
- To develop a comprehensive checklist to be used in operating theatres with robotic technology.
- Healthcare Failure Mode and Effects Analysis (HFMEA), a risk assessment tool, was used in a urology operating theatre with innovative robotic technology in a UK teaching hospital between June and December 2011.
- A 15-member multidisciplinary team identified ‘failure modes’ through process mapping and flow diagrams.
- Potential hazards were rated according to severity and frequency and scored using a ‘hazard score matrix’.
- All hazards scoring ≥8 were considered for ‘decision tree’ analysis, which produced a list of hazards to be included in a surgical safety checklist.
- Process mapping highlighted three main phases: the anaesthesia phase, the operating phase and the postoperative handover to recovery phase.
- A total of 51 failure modes were identified, 61% of which had a hazard score ≥8.
- A total of 22 hazards were finalised via decision tree analysis and were included in the checklist.
- The focus was on hazards specific to robotic urological procedures such as patient positioning (hazard score 12), port placement (hazard score 9) and robot docking/de-docking (hazard score 12).
- HFMEA identified hazards in an operating theatre with innovative robotic technologies which has led to the development of a surgical safety checklist.
- Further work will involve validation and implementation of the checklist.