Development of a checklist in risk management in thyroidectomy

Abstract

Introduction: Communication failures may result in inadequate treatment and patient harm, and are among the most common causes of sentinel events. Checklists are part of cycles to improve quality of the care process, promote communication between professionals involved in the different stages, help detect failures and risks, and increase patient safety. The lack of checklists at each stage was identified as a factor contributing to communication failures.

Objective: To design checklists at different stages of the thyroidectomy care process to improve the communication between the professionals involved.

Method: Multidisciplinary working team consisting of specialists in otolaryngology, anesthesiology, and endocrinology. The process of thyroidectomy was divided into three stages (preoperative -A-, operative -B- and postoperative -C-). Potential safety incidents and failures at each stage and their contributing factors (causes) were identified by literature review and brainstorming. Checklists for each checkpoint were designed by consensus of the working group.

Results: The items correspond to factors contributing to the occurrence of incidents in the perioperative stage of thyroidectomy related to patients, technological equipment, environment, management, and organization. Lists of items should be checked by the appropriate specialist in each stage.

Conclusions: Checklists in thyroid surgery are tools that allow for testing at different checkpoints data related to factors contributing to the occurrence of failures at each stage of the care process.

Keywords: Análisis de causa raíz; Checklist; Comorbidity; Comorbilidad; Control de riesgo; Factores de riesgo; Lista de verificación; Patient Safety; Risk factors; Risk management; Root cause analysis; Seguridad del paciente; Thyroidectomy; Tiroidectomía.