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ecords, instability of staff and managers, due to lack of financial motivation and attractionmigration, specially nurses and junior doctors.Also being carried in developing country the resources is to extent represent one of the basiclimitation specially in mainstreaming phase, because the trained staff is not motivated andretained used to migrate, on other hand the quality and safety systems need to be improvedspecially the reporting system of incidence and near misses which need more resources.5.3 Implications of the Change for ManagementThis change project with this great contribution of leaders, managers, and senior staff represent adifferent experience and create new spirit toward safety and quality applications. Extensive useof quality tool, capacity buildings, communication and teamwork establish new culture to theprofessionals such as cardiac surgeons. The finding of the evaluation confirms the internationalexperiences in the impact of the checklist implementation in creating teamwork, communication,and recall, through systematic check and orally team confirmation.On the side of service delivery implications, it improved the patient involvement, to ensure thecorrect person, correct site, and correct procedure. All cardiac surgical units applied the” SafeSurgery Saves Lives” initiative in all heart operations. This resulted in new safety culture,unifying the practice; to best practice, documentation systems strengthening, and reportingsystem for surgical errors established as a part of patient safety, enforce systemic check for riskarea and orally confirmation of main procedures.5.5 Recommendations for Future ImprovementsThis project data “the checklist data” should be computerized and connected with the patientmedical records and statistical departments. Quality management systems should be strengthened48
y improving the reporting system developing such as incidence, near miss events reportingsystem. Also infection controls program need some improvement. More studies, researches arerequired to measure the impact of the implementation on the patient morbidity and mortality.Human resources training and retaining should be strengthen.5.6. Reflections on the ProjectLeaded with my beliefs in Jack Welch‟s quote "If the rate of change on the outside exceeds therate of change on the inside, then the end is inside”. During the implementation of this project Iwas confident with the idea of the project since it is a best practice developed and evaluated byWorld Health Organization (WHO). This confidence increased with the nice dealing and respectoffered to me by the leaders, manager and staff, and dealing with I as expert and change leader.This greatly helped me to overcome obstacles and expected resistance. Despite all that, I wasalways thinking about how to fix a change in a changing environment since people, ideas, tools,and resources are always changing.Second thing that made me worried in the beginning of this project was the fact of implementingthis best practice in a developing country, suffering a week management system and poorresources. But my feeling was completely overturned.I really surprised with the effect of team work, communication, involvement and participation ineliminating the resistance, and enabling the change to happen. All partners who participated inthis change feel the ownership of it. I think this is one of49
Page 1 and 2: Royal College of Surgeons in Irelan
Page 3 and 4: Implementation of Safe Surgery Save
Page 6 and 7: 3.3.4 Mainstreaming ...............
Page 8 and 9: AbstractAim: This paper reports on
Page 10 and 11: Chapter 1Introduction1.1 Introducti
Page 12 and 13: Figure 1: Map of Piloted CitiesDeri
Page 14 and 15: Chapter 2Literature Review2.1 Intro
Page 16 and 17: The framework aims to represent a c
Page 18: 2.3 The checklistHealthcare relies
Page 21 and 22: healthcare staff by producing the S
Page 23 and 24: nature of many of these work system
Page 25 and 26: piloting, framing to promote Checkl
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
Page 33 and 34: meeting, where a surprising event h
Page 35 and 36: The change project team designed in
Page 37 and 38: performing the surgery will continu
Page 39 and 40: consent ,as the one previously used
Page 41 and 42: area was yet to encouraged as the c
Page 43 and 44: of the project. These incentives do
Page 45 and 46: medical and nursing staff before an
Page 47 and 48: Staff Opinion about Checklist87%98%
Page 49: Chapter 5Discussion and Conclusion5
Page 53 and 54: 5.6 ConclusionThe implementation of
Page 55 and 56: HSE. (2008, July). Improving ourser

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