1257 / Implementation of a checklist in the andrology laboratory

SPAIN
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Communication
Infection control / Prevention of surgical site infections There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
To assess the usefulness of a checklist as a tool to ensure the monitoring of the standard operating procedures in the laboratory of assisted reproduction, in accordance with the new legal provisions in Spain (Decree Law 9/2014), regulating the quality and safety in the handling of human gametes and embryos. The gynecology doctors indicate the source of gametes (from: fresh semen, frozen semen, fresh testicular biopsy, testicular biopsy frozen and donor sperm) used in each IVF cycle. The andrology laboratory personnel verifies that the sample of gametes indicated is correct. The implementation of the checklist is a tool for double check between the gynecology doctors and laboratory personnel of andrology to prevent errors and improve safety of assisted reproduction treatments The gynecology doctors indicate the source of gametes (from: fresh semen, frozen semen, fresh testicular biopsy, testicular biopsy frozen and donor sperm) used in each IVF cycle. The andrology laboratory personnel verifies that the sample of gametes indicated is correct. The implementation of the checklist is a tool for double check between the gynecology doctors and laboratory personnel of andrology to prevent errors and improve safety of assisted reproduction treatments.
Description of the Patient Safety Practice
 
Description of the security practice
We designed a verification checklist to record the details of procedure and the origin and characteristics of the gametes used in the cycles of in vitro fertilization (IVF). The initial draft was reviewed and approved by the members of the Security Kernel team. The explicit purpose of the questionnaire was to check the changes made in practice by the laboratory personnel, compared with the specifications of the IVF procedure previously scheduled by the gynecology doctors. Staff participants were informed and trained to fill in the checklist, and a pilot phase was run during a 5-month period (April-September of 2014). The data were analyzed by the medical documentation service.
Overall, 192 IVF treatments were recorded, and 159 checklists were completed (83% compliance). Discrepancies between the source of gametes planned and those actually used in the treatment were found in 14 cases (9%). One additional change of the treatment (0.6%) was due to a medical decision. The analysis of the reasons for the discrepancies revealed that in most of the cases (n=13) the programming sheet used for the doctors to begin the IVF treatment was outdated and did not provide some of the options newly available for the technique. As a result of the study, corrective measures were introduced to update the programming sheet in order to reflect all new technical options recently developed. Since the introduction of this checklist in the workflow of our IVF program, new items have been added to detect errors and to improve healthcare safety.
Results period : 1 December 2014 – 11 November 2015
- Number IVF: 476
- no check list complet: 412 (87%)
- discrepancies between the source of gametes planned and those actually used in the treatment: 13 (2,73%)
- chance of the treatment due to medical decision: 2 (0,42%)

Conclusions
The implementation of checklists into multidisciplinary activities involving different teams of professionals is an effective and dynamic tool of internal control to a) prevent incidents and adverse effects, b) improve the safety of the treatments, c) obtain objective and quantifiable measurements of errors in the transmission of decisions, d) facilitate organizational changes in some complex procedures, such as the IVF treatments.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Team level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Motivated staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Not relevant
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: PILAR BAXARIAS
Country: SPAIN
Organisation: FUNDACIÓ PUIGVERT
E-mail: pbaxarias@fundacio-puigvert.es
Phone: 93 4169700
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