The revised National Policy and Procedure for Safe Surgery has been recently launched in RCSI. The Policy, developed by the National Clinical Programmes, endorses the principles of the World Health Organisation (WHO) Surgical Safety Checklist (2008) and the HSE Patient Safety Strategy 2019-2024 to ensure that all patients undergoing surgical procedures, do so safely.

The guidelines, which are based on best practice and evidence, introduce key safety steps that should be incorporated into the operating theatre department, which will support the development of a safety culture and communication for operating teams. It applies to all patients undergoing surgery in the Irish hospital setting and all healthcare staff involved in the surgical patient pathway.

The safety steps for safe surgery, include briefing and debriefing to accompany sign in, time out and sign out.

Mr Kenneth Mealy, Co Lead for the National Clinical Programme in Surgery at RCSI, said: “Safe patient care should be central to everything that we do in surgery. Understanding that surgical error often arises from both system and individual failure, the HSE National Policy and Procedure for Safe Surgery 2022 defines ‘best practice’ at an organisational level in order to support surgical teams in their work. While the original WHO Surgical Safety Checklist forms the basis of this policy, the COVID-19 pandemic has reminded all of us of the need to periodically update and adapt all healthcare policies to reflect local use and changing circumstances. I urge all perioperative governance groups to disseminate this updated Policy and Procedure for Safe Surgery to all those working with patients along the surgical pathway.”

The HSE has committed to supporting services to maintain safe practices of care within high-risk environments such as surgery, to ensure that the correct procedure is performed on the correct patient and on the correct site on every occasion. Every member of the healthcare team involved in the patient pathway has a role to play in ensuring patient safety.

Dr Michael Dockery, Clinical Lead, National Clinical Programme for Anaesthesia, HSE, said: “This policy is an important update which will further improve the safety of patients undergoing surgery in Ireland and is to be welcomed for that reason.” 

Mr Paddy Kenny, Joint Clinical Lead for the National Clinical Programme for Trauma and Orthopaedic Surgery, HSE, said: “The programme welcomes and is delighted to support the updated policy on safe surgery. This is an important piece of work as patient safety is a key priority for the national clinical programme. The development of a checklist will ensure better communication within the team and better patient outcomes.” 

Dr Orla Healy, National Clinical Director of Quality and Patient Safety, HSE, said: “The National Quality Patient Safety Directorate are very pleased to endorse the launch of this policy. This policy forms a critical component in supporting the HSE patient safety vision that all patients will consistently receive the safest possible care, while recognising the complexity and risks associated with the delivery of that care. This policy provides guidance for safe practice throughout the surgical patient pathway and introduces key safety steps that can be incorporated into the operating theatre. Patient safety can be maximised and incidents minimised. The critical safety steps proposed are intended to support the development of a safety culture for operating departments and teams.”

The National Policy and Procedure for Safe Surgery 2022 provides a framework for improving communication and teamwork in surgical departments. It can also assist in changing the culture in operating departments by emphasising the importance of listening to all team members and valuing their contribution. 

This review was coordinated by the National Clinical Programmes for Anaesthesia in collaboration with the National Clinical Programme for Surgery, the National Clinical Programme for Trauma and Orthopaedic Surgery, stakeholders and patient representatives. 

The revised National Policy and Procedure for Safe Surgery and the accompanying audit tool are available to view here.