Improving utilisation of the WHO surgical safety checklist at Wollega University Referral Hospital: a multidimensional quality improvement project

Background The WHO surgical safety checklist aims to improve patient safety by standardising the delivery of care within the operating theatre through a series of essential safety checks. It is a cost-effective tool that has been shown to improve patient safety. However, its utilisation remains low. Objectives This quality improvement aimed to improve utilisation of the WHO surgical safety checklist at Wollega University Referral Hospital (WURH) from 56% to 100% from 1 July 2022 to 30 June 2023. Methods A hospital-based interventional study was conducted at WURH. A fishbone diagram and a driver diagram were used to identify root causes and how to address them. Six change ideas were developed. The Plan-Do-Study-Act cycle was used to test change ideas. The contribution of each change idea to the set objective was monitored. A run chart was used to assess whether an improved level of performance has been achieved and is being maintained. The result was presented using a run chart and graphs. Result The percentage of WHO surgical safety checklist utilisation improved from 56% to 100%. The highest percentages of WHO safe surgery checklist utilisation were recorded during the last 2 months of the project (May (100%) and June (100%)). All nursing staff in the operation theatre have received training on the WHO surgical safety checklist. Conclusion The compliance with WHO surgical safety utilisation was significantly improved at the study area. This was achieved through application of multidimensional change ideas related to health professionals and leadership. Therefore, we recommend the operation theatre team to make the WHO surgical safety checklist utilisation, its culture, and the hospital administration to conduct regular supportive supervisions and conducting a frequent clinical audit on its consistent utilisation. Additionally, in order to ensure the sustainability of the programme, hospital management should provide training to newly assigned staff as well as staff members who were not trained during the intervention phase.