What is it?
In September 2015, a document titled 'National Safety Standards for Invasive Procedures" was published by the NHS Improvement which focuses on "Never Events". LocSSIPs is the big recommendation to prevent "Never Events".
It stands for "Local Safety Standards for Invasive Procedure".
It is a tailored checklist for any invasive procedure performed in a hospital.
Why am I working on it?
When I first started this Medical Registrar job, the medical consultant proposed that I create LocSSIPs for the various procedures that we perform as the Respiratory Team. Frankly, prior to that meeting, I have no heard of LocSSIPs. The consultant struggled to even recall the acronym during our meeting. Yes, we had to google it during the meeting.
My experience in Anaesthetics and Intensive Care Unit tells me that a LocSSIP makes perfect sense. We have been doing checklist for years for various things but only formal recommendation is coming through for Local Invasive Procedures. The WHO Surgical Safety Checklist has been around since June 2008.
In Atul Gawande's "The Checklist Manifesto", he described the pros and cons for checklists. He drew lessons from other fields (ie Aviation Industry and Building Industry) and applied it into developing the WHO Surgical Safety Checklist. That book really opened my eyes to the fact that the Medical Industry is truly behind in regards of safety and adoption of technology to improve human health.
Developing LocSSIP part of my larger mission to improve the healthcare system wherever I am.
Where are you at now?
Frankly, not very far.
I am already facing questions like:
How detailed I need to go?
I am wary in making it too long hence unusable or not user friendly
Atul Gawande pointed out that a checklist should only be 30 seconds long or the uptake + retention would likely be poor.
Should I include a SOP (Standard Operating Procedure) in the second page?
Which currently does not exist in my current hospital. Which means I have to develop a one page SOP as well as this.
Or I could simply create the LocSSIP page and ignore the non-existance of a SOP, which seems negligent to me.
Do I colour code it the sections?
When do I indicate that the LocSSIP checklist be performed? (also known as Time-Out)
At the beginning?
At the end prior to entering the patient's room?
By the patient's bedside? (will this increase the confidence of the patient or make it worse?)
How I do introduce a reporting methology?
Do I insist that every LocSSIP is to be copied for auditing?
What font do I use?
etc etc
How will I overcome these challenges?
In Greg McKeown's book "Essentialism" Chapter 17: Progress: The Power of Small Wins, he talked about releasing "Minimally Viable Products" to achieve success and improvements. Perfectionism is never achieved from the drawing board into the first version of a product. We can only move closer to perfection with comments, criticism, feedback and new versions of said products.
Easier said than done. I am working on breaking down my identity of perfectionism.
Conclusion
Well... not much really. Work in progress.
Being a doctor is so much more than just dealing with patients. Don't get me wrong, this is great.