Ont. hospitals to use surgical safety checklist

Ontario hospitals will be required to use a surgical safety checklist and report on their compliance starting next spring as part of a government effort to improve patient safety, The Canadian Press has learned.

Hospitals already report on eight indicators of patient safety, such as C. difficile rates and hand washing.

The new rules, to be announced Thursday, will require hospitals to report publicly twice a year on whether they're following the checklist, starting July 31.

However, the first report is expected to include data about operations performed between April 1 and June 30.

The checklist includes 26 common tasks and items that surgeons and staff carry out to ensure patient safety in the province's operating rooms, such as:

• Checking equipment.
• Confirming patient information.
• Reviewing resuscitation plans.

The checklist is divided into three sections: tasks that must be completed before the anesthesia, before the incision and before the patient leaves the operating room.

It even requires surgeons, anesthesiologists and nurses to introduce themselves by name and role before the patient goes under the knife.

The checklist will apply to all surgeries and hospitals will have to report on the number of surgeries in which the checklist's tasks were completed.

C. difficile rates

Government sources say the list, which was developed in consultation with experts and the Ontario Hospital Association, will make the province's patient safety reporting regime the most comprehensive in North America.

They cite a study published in the New England Journal of Medicine in January that showed the implementation of surgical checklists helped reduce deaths and complications among patients.

The announcement will mark the first anniversary of public reporting of C. difficile rates in Ontario, which have declined by 30 per cent since hospitals started reporting them.

The province extended mandatory reporting of the infection and other hospital-acquired infections in the wake of an outbreak that caused or contributed to dozens of deaths in Ontario hospitals in 2007 and 2008.

In 2007, the Ontario coroner's office determined that C. difficile caused or contributed to 18 deaths at a Sault Ste. Marie hospital and suggested hospital overcrowding and out-of-date facilities may have contributed to the outbreak.

A Toronto-area hospital also battled more than a dozen cases that year that were positively identified as the same virulent strain that has claimed some 2,000 lives in Quebec since 2003.

In 2008, Joseph Brant Memorial Hospital in Burlington reported that C. difficile caused 62 patient deaths and 115 other infections between May 2006 and December 2007.

C. difficile is one of the most common infections in hospitals and nursing homes. The bacterium, which is found in feces, causes diarrhea and more serious intestinal conditions such as colitis.

Seniors and patients requiring prolonged use of antibiotics are at greater risk of infection, which can occur through physical contact after touching a contaminated surface.