Validated specific safety checklists for urological procedures can improve staff engagement and patient safety

Safety checklists have become an integral part of surgical practice. The aim of this quality improvement study was to identify and eliminate weaknesses within safety checklists for shockwave lithotripsy (SWL), flexible cystoscopy and transrectal ultrasound-guided (TRUS) biopsy of prostate. A root cause analysis was carried out into a case of incorrect side SWL treatment. Furthermore, we carried out a survey amongst staff regarding the suitability of our flexible cystoscopy and TRUS biopsy checklists. Following the introduction of new checklists, a satisfaction survey was sent to staff. The initial staff survey regarding flexible cystoscopy and TRUS biopsy identified at least three irrelevant questions on the checklist, with a further six with low–moderate importance. A single checklist was created for flexible cystoscopy and TRUS biopsy, whilst a separate checklist was developed for SWL. The follow-up satisfaction survey rated the new checklists as ‘satisfactory’ (82%) or ‘very satisfactory’ (18%). Appropriate checklists, with questions relevant to the procedure being undertaken will lead to greater staff satisfaction and engagement. This may lead to better staff participation, which is likely to reduce errors. 3