Effect of a two-year national quality improvement program on surgical checklist implementation

Summary Use of the surgical checklist in Switzerland is still incomplete and unsatisfactory. A national improvement program was developed and conducted in Switzerland to implement and improve the use of the surgical safety checklists. The aims of the implementation program were to implement comprehensive and correct checklist use in participating hospitals in every patient and in every surgical procedure; and to improve safety climate and teamwork as important cultural context variables. 10 hospitals were selected for participation in the implementation program. A questionnaire assessing use, knowledge, and attitudes towards the checklist and the Safety Climate Survey were conducted at two measurement occasions each in October/November 2013 and January/February 2015. Significant increases emerged for frequency of checklist use ( F (1,1001)  = 340.9, p F (1,1232)  = 25.6, p  0.001), and knowledge( F (1,1294)  = 184.5, p F (1,1284)  = 17.9, p F (1,1284)  = 7.8, p  0.01) were observed, this was not the case for attitudes (F (1,1283)  = .8, n.s. ) and acceptance (F (1,1284)  = 0.1, n.s.). Significant differences for safety climate and teamwork emerged in the present study (F (1,3555)  = 11.8, p  (1,3554)  = 24.6, p