Introduction
This research proposal aims to contribute to the field of perioperative care by identifying a novel approach to improving patient safety during surgical procedures. As a student studying Operating Department Practice (ODP), I am keenly aware of the critical importance of maintaining high standards of safety and communication in the operating theatre. A significant issue in perioperative care is the occurrence of preventable errors, often linked to lapses in checklist compliance or communication breakdowns. Therefore, this proposal introduces the development and evaluation of a digital checklist tool tailored for perioperative teams to enhance adherence to safety protocols. The research question guiding this study is: “How can the implementation of a digital checklist tool improve patient safety outcomes in perioperative care?” The aims are to assess the tool’s effectiveness in reducing errors, improving team communication, and ensuring compliance with safety protocols. This proposal will review relevant literature, outline the chosen methodology, and address ethical considerations to ensure the project’s feasibility for my final year of study.
Research Question and Aims
The primary research question is: “How can the implementation of a digital checklist tool improve patient safety outcomes in perioperative care?” This question is significant because patient safety remains a paramount concern in surgical settings, where errors can have severe consequences. The research aims are threefold: first, to evaluate the impact of a digital checklist tool on reducing perioperative errors, such as wrong-site surgery or missed safety checks; second, to investigate how the tool influences communication and collaboration among theatre staff; and third, to assess user satisfaction and barriers to adoption among perioperative teams. These aims address both clinical and human factors, contributing to a holistic understanding of safety interventions in the operating theatre.
Literature Review: Justifying the Research Idea
Patient safety in perioperative care has been a focal point of healthcare research since the introduction of the World Health Organization’s (WHO) Surgical Safety Checklist in 2008. Studies have demonstrated that checklist use significantly reduces morbidity and mortality rates by ensuring critical steps are not overlooked (Haynes et al., 2009). For instance, Haynes et al. (2009) found a 36% reduction in major complications following checklist implementation across diverse hospital settings. However, challenges persist, as paper-based checklists often suffer from incomplete adherence due to time constraints or inconsistent documentation (Treadwell et al., 2014). This limitation highlights the need for innovative solutions, such as digital tools, to improve compliance and accountability.
In contrast, emerging research on digital interventions suggests potential benefits over traditional methods. A study by Semel et al. (2010) explored electronic checklists in surgical settings and reported improved consistency in protocol adherence, though the sample size was limited, raising questions about generalizability. Conversely, critics argue that digital tools may introduce new risks, such as technological failures or over-reliance on automation, which could undermine clinical judgement (Bates & Gawande, 2003). Despite these concerns, the potential for real-time data tracking and user-friendly interfaces arguably outweighs the risks, provided robust training and support are in place. Therefore, this proposal seeks to build on existing evidence by designing a tailored digital checklist tool, addressing gaps in adherence and evaluating its impact on safety outcomes.
Methodology: Design and Rationale
This study will adopt a mixed-methods approach, combining quantitative and qualitative data to provide a comprehensive evaluation of the digital checklist tool. The research will be conducted in a single NHS hospital, focusing on elective surgical procedures over a six-month period. A pre- and post-intervention design will be used, where baseline data on error rates and checklist compliance will be collected before the tool’s introduction, followed by post-intervention data to measure changes. Quantitative measures will include the frequency of perioperative errors (e.g., wrong-site surgery or equipment miscounts) and compliance rates with safety protocols, obtained from hospital incident reports and audit logs. Qualitative data will be gathered through semi-structured interviews with theatre staff (n=10-15), exploring their experiences, satisfaction levels, and perceived barriers to using the tool.
The rationale for a mixed-methods approach lies in its ability to capture both numerical outcomes and nuanced human perspectives, ensuring a rounded evaluation. While quantitative data will provide objective evidence of the tool’s impact, qualitative insights will reveal contextual factors influencing adoption, such as staff attitudes or workflow disruptions. Data analysis will involve statistical tests (e.g., chi-square tests) for quantitative outcomes and thematic analysis for interview transcripts. This methodology aligns with the project’s scope as a final-year study, remaining feasible within time and resource constraints while offering meaningful contributions to perioperative care. Access to the hospital setting will be facilitated through academic-clinical partnerships, subject to ethical approval.
Ethical Considerations
Ethical principles are central to this research, ensuring participant welfare and project integrity. First, informed consent will be obtained from all theatre staff involved in interviews, with clear explanations of the study’s purpose, data usage, and their right to withdraw at any time. Patient data will not be directly collected; instead, anonymised hospital records on error rates will be accessed, adhering to data protection regulations such as the General Data Protection Regulation (GDPR) and NHS data governance policies. Confidentiality will be maintained by storing data securely on password-protected systems and using pseudonyms in reporting findings.
Furthermore, potential risks, such as staff feeling pressured to adopt the digital tool or experiencing workflow disruptions, will be mitigated through voluntary participation and phased implementation with adequate training. Ethical approval will be sought from the university’s research ethics committee and the NHS Trust’s governance board, ensuring compliance with national standards (NHS Health Research Authority, 2020). By embedding these safeguards, the project aims to balance innovation with respect for participants’ rights and well-being, creating a viable and responsible research design.
Conclusion
In summary, this research proposal addresses a pressing need in perioperative care by introducing a digital checklist tool to enhance patient safety. The research question and aims focus on evaluating the tool’s effectiveness in reducing errors, improving communication, and identifying barriers to implementation. The literature review justifies this idea by highlighting gaps in traditional checklist adherence and the potential of digital interventions, while acknowledging limitations such as technological risks. The mixed-methods methodology provides a practical and comprehensive approach to data collection, suitable for a final-year project. Moreover, robust ethical considerations ensure participant protection and project feasibility. If successful, this research could inform future safety initiatives in perioperative settings, contributing to better clinical outcomes and reinforcing the role of ODPs in driving innovation. The implications extend beyond immediate practice, potentially influencing policy on technology integration in healthcare. Ultimately, this proposal represents a step towards safer, more efficient surgical environments through evidence-based intervention.
References
- Bates, D.W. and Gawande, A.A. (2003) Improving safety with information technology. New England Journal of Medicine, 348(25), pp. 2526-2534.
- Haynes, A.B., Weiser, T.G., Berry, W.R., Lipsitz, S.R., Breizat, A.H., Dellinger, E.P., Herbosa, T., Joseph, S., Kibatala, P.L., Lapitan, M.C. and Merry, A.F. (2009) A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), pp. 491-499.
- NHS Health Research Authority (2020) UK Policy Framework for Health and Social Care Research. Health Research Authority.
- Semel, M.E., Resch, S., Haynes, A.B., Funk, L.M., Bader, A., Berry, W.R., Weiser, T.G. and Gawande, A.A. (2010) Adopting a surgical safety checklist could save money and improve the quality of care in U.S. hospitals. Health Affairs, 29(9), pp. 1593-1599.
- Treadwell, J.R., Lucas, S. and Tsou, A.Y. (2014) Surgical checklists: a systematic review of impacts and implementation. BMJ Quality & Safety, 23(4), pp. 299-318.
