Table 3

Reported personal behavioural change, grouped by theme

Using the checklistOver three-quarters of participants reported that they were always using the checklist, at least in part.
Two-thirds of respondents reported always using the checklist in its entirety.
Over two-thirds had started the process of counting needles, swabs and surgical instruments for every surgical case.
"We see what you have taught us is so very important for the safety of our patients". (H4)
"I now always use the Checklist for every surgery when I am in the Operating Room". (H8)
Two hospitals had decided to print copies of the checklist and counting sheets and keep these with the operating logbook and were able to show us piles of completed forms; many other hospitals had posted the laminated checklist on the wall in the operating room which was verified when possible by the evaluation team.
Improved monitoring and diligenceOver half of participants reported improving their practices regarding safety protocols such as patient verification and use of improved monitoring using donated Lifebox pulse oximeters."It really gives me peace of mind that I know the team is checking the patient ID and counting materials". (H5)
One anesthetist relayed an experience he had of an emergency hysterectomy patient. She appeared to be stable following surgery and the anesthetist was focused on other patients, but kept his improved monitoring on the patient (Lifebox pulse-oximeter) which they wouldn’t have done previously. He was alerted by the Lifebox alarm, and found the patient close to collapse and deteriorating fast. They immediately retrieved an oxygen concentrator, urgently located blood for transfusion and were able to resuscitate the patient in time. He said he doesn’t believe they would have managed to save her if they hadn’t been alerted by the monitoring equipment that something was wrong. (H9)
Improved teamwork and communicationChanges reported at both personal and organisational levels. Many participants reported being more aware of the team nature of patient safety; this affected their personal behaviour in that they felt more a part of the team, able to speak up on behalf of the patient or team and felt more engaged in ensuring patient safety as a priority."We are more aware of other people’s needs on the team and helping each other". (H18)
"We don’t start now without everyone being in the room, it means everyone is on time!” (H16)
Another nurse reported they are much more communicative at patient handover, which is helpful for the patient and the ward nurses receiving post-op patients (H15).