Implementation of Safe Surgery Saves Lives initiative in Ahmed ...

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4.5. SummaryDespite that AGCC is not accredited hospital by any national or international organization; thereare valued local efforts to improve the quality of the services. There is a lot of improvementprocesses going on. Nevertheless, still there was no previous experience with a well-documentedchange project or improvement in AGCC.Generally, the project through extensive uses of quality tools create a new sense, increased thecommunications, and teamwork culture between the managers and clinical staff. Due to thenature of project itself, the project is introducing new cultures like leadership, management tools,and management practices to the surgery team such as communications, teamwork, riskmanagement, and systematic check with oral confirmation to the rest of team since everything isdocumented by the checklist. The evaluation of the long term impact such as mortality andmorbidity is out of the scope of this paper, but it is recommended to be done later.The main aim of the project which was implementing the WHO surgical safety checklist wassuccessfully achieved. With regard to the services delivery, the five cardiac surgeons and theirstaff unified work standards, and stick to the safe surgery saves lives guidelines.The all participated in designing the change and modifying the checklist. The efforts done incommunication with them and other staff eliminated the resistance, reduced the fear fromunknown and kept the personal powers as it is. This approach has led to the full involvement ofall staff, moreover, the belief that this change is their own work, and has led to appreciating ourefforts in initiating and facilitating the change process.On the management side, the extensive work done in the situation analysis and communicationwith clinical staff created many improvement projects, and clear the pathways for development.46
Chapter 5Discussion and Conclusion5.1 IntroductionThe HSE change model is enabling continuous and ongoing discussion, evaluation, andinteracting phases, throughout the initiation, planning, and implementation and mainstreaming.The results in short term evaluation confirm and support the international experiences with safesurgery initiative implementation.5.2 Strengths and limitations of the projectThe strengths of the project embodied in the nature of it, as it addressing safety in healthcaresetting providing a very high risk cases. The attractive vision, global implementation, withevidence based designed tool by WHO expertise, and evaluated outcomes in piloted cities andproved effectiveness. On the side the AGCC as highly specialized center, with the best possiblestandards in the country, also the highly committed leaders of health authorities in the ministry ofHealth, and AGCC leaders and managers on all level, this in addition, to cooperative welleducatedstaff, and fortunately, one of the surgeons participated in the WHO pilot study when hewas in Canada 2008.The major limit of this change project was the time period, where it is not possible to evaluatethe long term impact of the Checklist on cardiac surgery in AGCC such as reduction of mortalityand morbidity rates, in spite of that the evaluation of the impact is not one of aims of the projectto validate the tool because it is already evaluated by WHO pilot study in 2008. Also, limitationsof AGCC work systems of quality, chain supply, and training. No functioning reporting systemof incidence and near misses, limited used of available technology and paper based medical47
Page 1 and 2: Royal College of Surgeons in Irelan
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Page 8 and 9: AbstractAim: This paper reports on
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Page 27 and 28: Chapter 3Methods3.1 IntroductionThe
Page 29 and 30: Time out phase:Before skin incision
Page 31 and 32: 3.3.1 InitiationThe purpose of this
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Page 35 and 36: The change project team designed in
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