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To preserve the bladder without compromising survival, further treatments need to be optimized to prevent the recurrence and progression of non‐muscle invasive bladder cancer. In clinical practice, transurethral resection of bladder tumors is essential for bladder cancer management. The primary goal of surgery is to achieve accurate pathological evaluation and complete resection of bladder cancer; high resection quality is required for the procedure. A representative surrogate indicator of the resection quality is the presence of the detrusor muscle in the resection specimen. Therefore, complete visual resection of bladder cancer with a muscle layer is crucial for decreasing the recurrence and progression rates of non‐muscle‐invasive bladder cancer. However, this procedure is complex and requires sufficient experience and knowledge to be performed thoroughly, safely, and efficiently. Surgical checklists represent an approach to filling the knowledge and experience gaps and improving the quality and safety of surgery. By checking items during transurethral resection, it is expected that the recording of risk factors related to recurrence and progression will improve, the rate of visually complete resection with muscles will increase, and the rate of intravesical recurrence will decrease. The simplicity of checklists is an additional benefit. In recent years, surgical checklists have received increasing attention in order to achieve high‐quality resections and reduce disparities between surgeons and institutions. This literature review outlines the evolving treatment strategies for patients with non‐muscle‐invasive bladder cancer, focusing on surgical checklists for the transurethral resection of bladder tumors. [ABSTRACT FROM AUTHOR]

Objective: To elucidate the therapeutic benefits of using a surgical checklist during transurethral resection for non‐muscle‐invasive bladder cancer. Methods: A nine‐item surgical checklist was established in January 2016 to assess disease risk and resection adequacy, and it was prospectively implemented into clinical practice. Patients diagnosed with non‐muscle‐invasive bladder cancer who underwent complete resection from January 2009 to August 2019 were included in this study. The presence of detrusor muscle in the transurethral resection specimen and the intravesical recurrence‐free survival were compared between patients who underwent transurethral resection before and after surgical checklist implementation. Results: A total of 125 patients who underwent transurethral resection after surgical checklist implementation were reviewed and compared with 125 patients who underwent transurethral resection before surgical checklist implementation. The use of the surgical checklist led to an increase in the proportion of transurethral resection specimens containing detrusor muscle (92% vs 69.6%, P < 0.01) and a decrease in the recurrence rate (19.2% vs 49.6%, P < 0.01). Multivariate analysis showed that transurethral resection without a surgical checklist was an independent predictive factor influencing the absence of detrusor muscle in the transurethral resection specimen (odds ratio 4.78, P < 0.01) and intravesical recurrence (hazard ratio 1.92, 95% confidence interval 1.14–3.23; P = 0.01). Kaplan–Meier plots showed that the recurrence‐free survival rate was significantly lower when the surgical checklist was not used (log‐rank test result P < 0.01). Conclusions: This study shows the therapeutic benefits of surgical checklist in improving the quality of resection during transurethral resection and reducing the recurrence rate in patients with non‐muscle‐invasive bladder cancer. [ABSTRACT FROM AUTHOR]

Objective: To examine if attending surgeon presence at the preinduction briefing is associated with a shorter time to incision.Study Design: Retrospective cohort study and survey.Setting: Tertiary academic medical center.Subjects and Methods: A retrospective cohort study was conducted of 22,857 operations by 141 attending surgeons across 12 specialties between August 3, 2016, and June 21, 2018. The independent variable was attending surgeon presence at the preinduction briefing. Linear regression models compared time from room entry to incision overall, by service line, and by surgeon. We hypothesized a shorter time to incision when the attending surgeon was present and a larger effect for cases with complex surgical equipment or positioning. A survey was administered to evaluate attending surgeons' perceptions of the briefing, with a response rate of 68% (64 of 94 attending surgeons).Results: Cases for which the attending surgeon was present at the preinduction briefing had a statistically significant yet operationally minor reduction in mean time to incision when compared with cases when the attending surgeon was absent. After covariate adjustment, the mean time to incision was associated with an efficiency gain of 1.8 ± 0.5 minutes (mean ± SD; P < .001). There were no statistically significant differences in the subgroups of complex surgical equipment and complex positioning or in secondary analysis comparing service lines. The surgeon was the strongest confounding variable. Survey results demonstrated mild support: 55% of attending surgeons highly prioritized attending the preinduction briefing.Conclusion: Attending surgeon presence at the preinduction briefing has only a minor effect on efficiency as measured by time to incision. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the impact of an eight‐item surgical checklist (SC) on the recurrence‐free survival (RFS) of patients with non‐muscle‐invasive bladder cancer (NMIBC) undergoing transurethral resection of bladder tumour (TURBT). Patients and Methods: A group of urologists at two tertiary referral centres, with expertise in bladder cancer, identified eight critical items that should be performed in every high‐quality TURBT. An eight‐item SC was prospectively implemented into clinical practice and the operative reports of TURBTs performed before and after implementation were reviewed. Results from both institutions were combined to estimate the impact of introducing the SC on oncological outcomes. Multivariable logistic and Cox hazards regression analyses were performed to evaluate the impact of the SC on the presence of detrusor muscle in the TURBT specimen and on RFS, respectively. Results: The operative reports of 266 TURBTs performed after the SC implementation were reviewed and compared to those of 281 TURBTs performed prior to the SC introduction. The SC was independently associated with a significant improvement in RFS (P = 0.02). However, the introduction of the SC was not significantly associated with the presence of detrusor muscle in the surgical specimen (P = 0.4). Conclusion: The use of an eight‐item SC during TURBT in clinical practice increases the quality of operative reports thereby potentially improving individualised risk‐stratification and care resulting in lower disease recurrence rates. Therefore, the introduction of a SC can be recommended to enhance oncological outcomes by improving surgical standardisation and operative reporting. [ABSTRACT FROM AUTHOR]

Surgery is complex and technically demanding for all team members. Surgical checklists have been implemented with different degrees of success in the perioperative setting. There is a wealth of evidence that they are effective at preventing patient safety events and helping team members master the complexities of modern health care. Implementation is key to successful use of the surgical checklist in all invasive procedural settings. Key strategies for successful checklist implementation include establishing a multidisciplinary team to implement the checklist, involving surgeon leaders, pilot testing the checklist, incorporating feedback from team members to improve the process, recognizing and addressing barriers to implementation, and offering coaching and continuous feedback to team members who use the checklist. Using these strategies will give the perioperative nurse, department leaders, and surgeons the tools to implement a successful checklist. [ABSTRACT FROM AUTHOR]

Introduction The World Health Organisation's ( WHO) surgical safety checklist was introduced in 2008. We describe a model for implementation of the surgical safety checklist in an oral surgery-teaching department and present the results of an audit of compliance as well as a review of relevant critical incidents. Method An adapted checklist for all surgical procedures was developed and introduced into our oral surgery-teaching department as a pilot in 2009 and as a protocol in 2010. Feedback regarding the pilot phase of checklist implementation was obtained from clinical staff, and 2 years of audit data relating to compliance with the surgical checklist was collected. Submissions of critical incidents over a 4-year period, prior to and after surgical checklist introduction, were also analysed. Results Feedback in the pilot phase of surgical checklist implementation from clinical staff was generally positive. Audit results display increasing levels of compliance with the checklist process in our unit. Two out of 102 critical incident reports reviewed were found to be relevant to the surgical checklist process and are presented. Conclusion The WHO surgical safety checklist can be successfully implemented in an oral surgery-teaching hospital setting. Levels of compliance with the checklist in our unit are high. Demonstrating an improvement in outcomes since the introduction of the checklist is a challenge, but there is limited evidence of improved patient care from reviewing critical incident data in our unit. [ABSTRACT FROM AUTHOR]

We evaluated the impact of the World Health Organization Obstetric Safe Surgery Checklist ( WHO Checklist) on perioperative communication between anaesthetists and obstetricians by performing a retrospective audit in a Teaching hospital in London, UK. Caesarean section births from February to March 2009 and April to May 2011 were studied. Caesarean section notes from obstetricians and anaesthetists managing the same woman during the study period were reviewed. Grading differences between obstetricians and anaesthetists before and after checklist introduction were evaluated. Communication failure (where obstetricians and anaesthetists had documented different caesarean section grades [level of urgency]) and good communication (where obstetricians and anaesthetists had documented the same caesarean section grade) were observed. In total, 195 caesarean sections before introduction of the WHO safe surgery checklist and 194 caesarean sections after checklist introduction were studied. Grading differences occurred in 24.1% of caesarean sections without checklists compared with 10.3% with checklists ( P < 0.001). During emergency caesarean section alone, grading differences between obstetricians and anaesthetists were smaller, although this was not significant ( P = 0.222). We conclude that implementation of a WHO Obstetric Safe Surgery checklist improves the communication of caesarean section grade (urgency) between obstetricians and anaesthetists. [ABSTRACT FROM AUTHOR]