A South Carolina hospital's surgical checklist adoption rate was 30%. Why it's now 100%

When resistance to change mounts, leaders who empathize with resisters are much more effective than those who fight back, according to Harvard Business Review.  

Michael Rose, MD, an anesthesiologist and former vice president of surgical services at McLeod Health in Florence, S.C., experienced resistance from his surgical teams when deploying a surgical checklist. The checklist aimed to reduce errors and improve patient outcomes.

From 2009-10, Dr. Rose spent 18 months talking up the checklist, leading training, persuading colleagues and requiring its use. Still, McLeod only reported a 30 percent adoption rate. Dr. Rose decided to pivot his approach to three key mind shifts: "Don't fight the resisters"; "Stop telling people what changes to make"; and, "Focus on the people who already are committed to change."

In doing so, McLeod's surgical teams began to buy in to the checklist, and now use it 100 percent of the time. After implementing the checklist, McLeod's 30-day surgical mortality rate dropped nearly a third. Its surgical teams' productivity grew seven and a half hours per case, for a savings of $4 million each year. Its surgical cases increased, leading to more than $3 million in additional annual revenue.

On top of that, McLeod's surgical team has reported higher job satisfaction and a stronger culture of safety among workers, according to the report.

"As [Dr.] Rose sees it, the surgical team members not only saved others' lives by adopting the checklist, they also improved the staff's well-being and renewed their spirits," according to Harvard Business Review.

For the full report, click here.

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