AAOS Bulletin - June, 2006

Patient Safety checklists: Capture information, improve communication

Looking for a way to improve the flow of information in your office-based or ambulatory surgery center? Need a tool to capture information about which supplements, vitamins and herbs your patients may be taking? The Patient Safety Committee has just what you’re looking for on the AAOS patient safety Web site.

The AAOS is dedicated to improving patient safety by implementing programs that will ensure that patient safety is a cornerstone of orthopaedic practice. To assist physicians’ efforts to improve patient safety in office-based and ambulatory surgery centers, the AAOS has developed patient safety checklists for preoperative and postoperative use. An intake form has also been designed to address the increased use of dietary supplements and aid in the review of patient medication practices. These simple, straightforward lists serve as efficient ways to capture and share important patient information.

Preoperative checklist

The ambulatory surgery and office-based surgery preoperative and postoperative checklists offer a concise format for verifying key patient information. The preoperative checklist ensures that the surgeon has considered issues related to a particular patient for the specific procedure, and confirms that certain safety-related processes have been performed prior to entering the operating room. The list also verifies that the patient’s history and physical have been performed, and that the surgical site has been signed by the surgeon.

This checklist also functions as a quick way for members of the ambulatory and office-based surgery teams to share information with each other. Rather than search the chart for the history and physical or preoperative notes, anesthesiology staff can look at the form to see if the surgeon has discussed prior anesthetic complications with the patient, and operative-suite staff can confirm that the necessary equipment is present and is functioning properly.

Postoperative checklist

The postoperative checklist addresses issues related to the safety of the patient at discharge. The form contains space for follow-up appointment details and confirms that the patient or his or her designee has received discharge and medication instructions. As with the preoperative checklist, the postoperative checklist enables staff to share information with each other, as well as with the patient. The checklist includes space for the initials of the office or ambulatory surgery center representative who provides the patient or designee with medication and discharge instructions. For example, the checklist enables the staff member who assists the patient with follow-up appointment information to confirm that his or her colleague has received and reviewed discharge instructions with the patient.

Dietary supplement intake form

The dietary supplement intake form gives health-care providers a simple way to begin a complicated conversation. The form includes a list of common dietary supplements and space for patients to indicate the dose, frequency and primary reason for taking the supplement. This tool is recommended as an aid in identifying potential interactions and is particularly useful for helping patients understand the risks, as well as the benefits, involved with supplement usage. The dietary intake supplement form may be used for inpatients as part of the preoperative workup in an office-based or ambulatory surgical center. The form is most effective when patients can complete it at home, where they have access to the supplements and their packaging. Patients may also complete the form online and bring it with them on their first appointment.

The preoperative and postoperative checklists work best when clipped directly to the patient chart, and are completed and signed by the orthopaedic surgeon and his or her staff. All five forms may be used in conjunction with other checklists, preoperative and discharge instruction sheets or other patient education forms. The forms can be found online on the patient safety section of the AAOS Web site

Ambulatory Surgery Preoperative Checklist

Ambulatory Surgery Postoperative Checklist

Office-based Surgery Preoperative Checklist

Office-based Surgery Postoperative Checklist

Dietary Supplement Intake Form


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