Safer surgery through simulation: increasing compliance with the 5 Steps to Safer Surgery through an in-situ simulation based training programme at Guy’s and St Thomas’ NHS Foundation Trust

The WHO Surgical Safety Checklist is shown to reduce mortality from 1.5% to 0.8% and inpatient complications from 11% to 7%.1 Following a review, the National Patient Safety Agency added briefing and debriefing to the checklist to create the 5 Steps to Safer Surgery (5SSS). At Guy’s and St Thomas’ NHS Foundation Trust, the Care Quality Commission (CQC) and local audits reported less than optimal compliance with the 5SSS across all operating theatres, particularly with the debrief, where completion of this was as low as 0% in some departments. One reason was a lack of engagement from surgical consultants.2 Studies have shown that a high regard for the checklist and participation in team training with a focus on healthcare crew resource management (also known as Non-Technical or Human Factor (HF) skills) is associated with fewer post-operative complications.3 4 Therefore, we created an in-situ simulation based training programme to enhance compliance with the 5SSS and the safety culture within the Trust.The half-day training programme was run three times between August and November 2017 for doctors, nurses and radiologists of the Interventional Radiology (IR) department, a para-surgical specialty with one of the lowest compliance rates in the Trust. Each day began by going through an introduction, including an icebreaker, aims for the day, an overview of the 5SSS and HF and their contribution to preventing errors and improving safety. The group was then taken …