Development and content validation of a surgical safety checklist for operating theatres that use robotic technology

Authors

  • Kamran Ahmed,

    Corresponding author
    1. MRC Centre for Transplantation, King's College London, King's Health Partners, Department of Urology, Guy's Hospital, London, UK
    • Correspondence: Kamran Ahmed, Urology Registrar/Hon Clinical Lecturer, MRC Centre for Transplantation, King's College London, Guy's Hospital, St Thomas Street, London SE1 9RT, UK.

      e-mail: k.ahmed@imperial.ac.uk

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  • Nuzhath Khan,

    1. MRC Centre for Transplantation, King's College London, King's Health Partners, Department of Urology, Guy's Hospital, London, UK
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  • Mohammed Shamim Khan,

    1. MRC Centre for Transplantation, King's College London, King's Health Partners, Department of Urology, Guy's Hospital, London, UK
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  • Prokar Dasgupta

    1. MRC Centre for Transplantation, King's College London, King's Health Partners, Department of Urology, Guy's Hospital, London, UK
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Abstract

Objectives

  • 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.

Methods

  • 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.

Results

  • 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).

Conclusions

  • 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.

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