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Implementation of a colour-coded universal protocol safety initiative in Guatemala.

Publication ,  Journal Article
Taicher, BM; Tew, S; Figueroa, L; Hernandez, F; Ross, SS; Rice, HE
Published in: BMJ Qual Saf
August 2018

BACKGROUND: Universal protocol implementation can be challenging in low-income or middle-income countries, particularly when providers work together across language barriers. The aim of this quality improvement initiative was to test the implementation of a colour-coded universal protocol in a Guatemalan hospital staffed by US and Guatemalan providers. METHODS: From 2013 to 2016, a US and Guatemalan team implemented a universal protocol at a Guatemalan surgical centre for children undergoing general surgical or urologic procedures. The protocol was a two-step patient identification and documentation checklist, with the first step of all chart element verification in the preoperative area, after which a blue hat was placed on the patient as a visual cue that this was completed. The second step included checklist confirmation in the operating room prior to the procedure. We tested protocol implementation over three phases, identifying implementation barriers and modifying clinical workflow after each phase. We measured the error rate in documentation or other universal protocol steps at each phase and made modifications based on iterative analysis. RESULTS: Over the course of programme implementation, we substantially decreased the rate of errors in documentation or other universal protocol elements. After the first phase, 30/51 patients (58.8%) had at least one error. By the third phase, only 2/43 patients (4.6%) had any errors. All errors were corrected prior to surgery with no adverse outcomes. CONCLUSIONS: Care teams of providers from different countries pose potential challenges with patient safety. Implementation of a colour-coded universal protocol in this setting can prevent and reduce errors that could potentially lead to patient harm.

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Published In

BMJ Qual Saf

DOI

EISSN

2044-5423

Publication Date

August 2018

Volume

27

Issue

8

Start / End Page

593 / 599

Location

England

Related Subject Headings

  • United States
  • Quality Improvement
  • Pediatrics
  • Patient Safety
  • Outcome and Process Assessment, Health Care
  • Operating Rooms
  • Medical Errors
  • Humans
  • Health Policy & Services
  • Health Personnel
 

Citation

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Taicher, B. M., Tew, S., Figueroa, L., Hernandez, F., Ross, S. S., & Rice, H. E. (2018). Implementation of a colour-coded universal protocol safety initiative in Guatemala. BMJ Qual Saf, 27(8), 593–599. https://doi.org/10.1136/bmjqs-2017-007217
Taicher, Brad M., Shannon Tew, Ligia Figueroa, Fausto Hernandez, Sherry S. Ross, and Henry E. Rice. “Implementation of a colour-coded universal protocol safety initiative in Guatemala.BMJ Qual Saf 27, no. 8 (August 2018): 593–99. https://doi.org/10.1136/bmjqs-2017-007217.
Taicher BM, Tew S, Figueroa L, Hernandez F, Ross SS, Rice HE. Implementation of a colour-coded universal protocol safety initiative in Guatemala. BMJ Qual Saf. 2018 Aug;27(8):593–9.
Taicher, Brad M., et al. “Implementation of a colour-coded universal protocol safety initiative in Guatemala.BMJ Qual Saf, vol. 27, no. 8, Aug. 2018, pp. 593–99. Pubmed, doi:10.1136/bmjqs-2017-007217.
Taicher BM, Tew S, Figueroa L, Hernandez F, Ross SS, Rice HE. Implementation of a colour-coded universal protocol safety initiative in Guatemala. BMJ Qual Saf. 2018 Aug;27(8):593–599.

Published In

BMJ Qual Saf

DOI

EISSN

2044-5423

Publication Date

August 2018

Volume

27

Issue

8

Start / End Page

593 / 599

Location

England

Related Subject Headings

  • United States
  • Quality Improvement
  • Pediatrics
  • Patient Safety
  • Outcome and Process Assessment, Health Care
  • Operating Rooms
  • Medical Errors
  • Humans
  • Health Policy & Services
  • Health Personnel