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Implementation of safety checklists in surgery: a realist synthesis of evidence

Overview of attention for article published in Implementation Science, September 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (96th percentile)

Mentioned by

blogs
2 blogs
twitter
36 X users
facebook
1 Facebook page

Citations

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97 Dimensions

Readers on

mendeley
281 Mendeley
citeulike
1 CiteULike
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Title
Implementation of safety checklists in surgery: a realist synthesis of evidence
Published in
Implementation Science, September 2015
DOI 10.1186/s13012-015-0319-9
Pubmed ID
Authors

Brigid M. Gillespie, Andrea Marshall

Abstract

The aim of this review is to present a realist synthesis of the evidence of implementation interventions to improve adherence to the use of safety checklists in surgery. Surgical safety checklists have been shown to improve teamwork and patient safety in the operating room. Yet, despite the benefits associated with their use, universal implementation of and compliance with these checklists has been inconsistent. An overview of the literature from 2008 is examined in relation to checklist implementation, compliance, and sustainability. Pawson's and Rycroft-Malone's realist synthesis methodology was used to explain the interaction between context, mechanism, and outcome. This approach incorporated the following: defining the scope of the review, searching and appraising the evidence, extracting and synthesising the findings, and disseminating, implementing, and evaluating the evidence. We identified two theories a priori that explained contextual nuances associated with implementation and evaluation of checklists in surgery: the Normalisation Process Theory and Responsive Regulation Theory. We identified four a priori propositions: (1) Checklist protocols that are prospectively tailored to the context are more likely to be used and sustained in practice, (2) Fidelity and sustainability is increased when checklist protocols can be seamlessly integrated into daily professional practice, (3) Routine embedding of checklist protocols in practice is influenced by factors that promote or inhibit clinicians' participation, and (4) Regulation reinforcement mechanisms that are more contextually responsive should lead to greater compliance in using checklist protocols. The final explanatory model suggests that the sustained use of surgical checklists is discipline-specific and is more likely to occur when medical staff are actively engaged and leading the process of implementation. Involving clinicians in tailoring the checklist to better fit their context of practice and giving them the opportunity to reflect and evaluate the implementation intervention enables greater participation and ownership of the process. A major limitation in the surgical checklist literature is the lack of robust descriptions of intervention methods and implementation strategies. Despite this, two consequential findings have emerged through this realist synthesis: First, the sustained use of surgical checklists is discipline-specific and is more successful when physicians are actively engaged and leading implementation. Second, involving clinicians in tailoring the checklist to their context and encouraging them to reflect on and evaluate the implementation process enables greater participation and ownership.

X Demographics

X Demographics

The data shown below were collected from the profiles of 36 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 281 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 3 1%
Indonesia 1 <1%
Germany 1 <1%
Canada 1 <1%
Unknown 275 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 56 20%
Researcher 32 11%
Student > Bachelor 27 10%
Student > Ph. D. Student 25 9%
Student > Doctoral Student 23 8%
Other 56 20%
Unknown 62 22%
Readers by discipline Count As %
Medicine and Dentistry 73 26%
Nursing and Health Professions 61 22%
Social Sciences 17 6%
Business, Management and Accounting 10 4%
Psychology 8 3%
Other 40 14%
Unknown 72 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 35. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2019.
All research outputs
#1,061,506
of 23,874,480 outputs
Outputs from Implementation Science
#183
of 1,743 outputs
Outputs of similar age
#15,865
of 277,675 outputs
Outputs of similar age from Implementation Science
#3
of 50 outputs
Altmetric has tracked 23,874,480 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,743 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.8. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,675 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 50 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 96% of its contemporaries.