Provision of quality health care is an imperative component of every health institution. Medical ethics deem it necessary for medical practitioners to ensure that they provide medical services with utmost proficiency to their patients. The surgical checklist is instrumental in enhancing the safety of surgical patients in the operating room. The surgical checklist is a universally acclaimed safety measure for the surgical patient as it decreases mortality and complications arising from the surgical process (Conley et al., 2011). Health care encompasses a myriad of fundamental issues that should be highly considered; the safety of patients and the highest level of aptitude from the medical practitioners are priority issues that deem proper attention. Despite the importance of the surgical checklist, it is evident that there are inconsistencies in its usage, which jeopardize the safety of surgical patients (Baumer, 2005).

In order to counteract the system flaws and complications arising from inconsistencies in the usage of the surgical checklist, retraining on the implementation of the AORN surgical checklist is a feasible option.

I. Implementation Plan

The overall plan for implementing the proposed solution

Based on the imperative nature of health care and surgical patients’ safety, the implementation plan calls for deliberate efforts from the medical practitioners involved in the operating room; the plan involves laying a firm foundation on the importance of the surgical checklist. At this point, it is worth noting that the viable implementation of the surgical checklist in the operating room or the health care arena requires the participation of virtually every medical practitioner involved in the process. In essence, the overall implementation plan is a team work effort as opposed to individual execution.

Implementing the solution requires the surgical team to have an in-depth awareness of quality of care and the significance of patient safety (Young-Xu, et al., 2011). Training the surgical team on the basic elements of quality of care in relation to the usage of the surgical checklist will go a long way in reducing the complications and mortality levels stemming from the failure to use the checklist. Consistent use of the surgical checklist has profound effects in enhancing patient safety in the operating room (Bell and Pontin, 2010)). Particularly, in the time out process, the complete adherence to the surgical checklist is significant in enforcing the require safety surgical standards. Therefore, the implementation plan involves providing a platform whereby surgical teams have deep awareness on quality care from a health care perspective; hence, putting great emphasis on patient safety.

Setting awareness standards on patient safety will ultimately require the consistent use of the surgical checklist by surgical teams.

Retraining on the implementation of the AORN surgical checklist also considers communication as an important aspect in the enhancement of safety measures in the
operation room. Research shows that ineffective communication has contributed to the depreciating nature of safety in surgical environments (Espin et al., 2005). Thus, effective communication among medical practitioners will be instrumental in enhancing the quality of care required in operating rooms. The ability of the surgical teams to participate collectively especially in the time-out process, there is need for effective communication by following the surgical checklist standards. Therefore, training the surgical teams on effective communication is an elemental component in the feasible implementation of the surgical checklist.

Moreover, implementation of the proposed solution deems it necessary for a strategy that fosters flexibility in accommodating the variability among surgical members. The inconsistent use of the surgical checklist comes from the varying perceptions of those responsible in operating rooms (Hurlbert and Garrett, 2009). Thus, the proposed solution encompasses the implementation of flexible strategies that identify operational variability and fosters efficiency among the surgical members. With adequate consideration on those factors, the use of the surgical checklist will enable the medical practitioners to put emphasis on surgical patients’ needs. Consequently, the proposed solution will increase the use of the checklist and promote high involvement from the surgical team.
Resources needed for the proposed solution’s implementation

As mentioned above, implementing the proposed plan calls for the concerted efforts of the relevant members in the health care process. Since the health care realm encompassed by the proposed solution is surgery, the resources needed in the proposed solution are surgeons, anesthetists and nurses. Since these medical practitioners are predominantly involved in the operating room, they are the most significant resources in the implementation of the solution. Furthermore, they are mandated to use the surgical checklist in the execution of their duties; hence, being primary resources in the implementation of the solution. Additionally, the leadership fraternity in the hospital is also instrumental in the implementation of the solution.

The leadership, may be the Chief Medical Officer, is responsible for setting the strategies for implementation as well as the monitoring procedures for the proposed solution. The hospital leadership is pertinent in ensuring a smooth transition through the stages of implementation. Finances for the training of surgeons, anesthetists and nurses are also required.

Methods for monitoring solution implementation

The methods for monitoring solution implementation are vital in assessing the productivity of the process. In respect to the retraining on the implementation of the surgical checklist, there are various methodologies of monitoring the process.

Firstly, assessing the quantity and quality of information being exchanged by the surgical team members is a reliable step in ascertaining the level of change. Consistent use of the surgical checklist requires effective and deliberate exchange of information among the team members (Gowanda, 2010). Hence, monitoring the progress of the solution through the quality and quantity of information shared is sufficiently viable.

Secondly, evaluating consistency in the management of surgical activities within the required timings will also form a feasible monitoring ground for the implementation process. Since the surgical checklist contains different tasks within different time frames, monitoring the management of tasks among the members will ascertain the degree of implementation.

Moreover, establishing the level of cooperation among the surgical team members will also contribute significantly the monitoring of the proposed solution. Using the surgical checklist in the operating room requires teamwork from the medical practitioners. The Time-Out process in the operating room requires the effective participation of the surgical members (Guzik, 2013). Thus, the perceptions and effective contributions of the members in the time-out process are critical in monitoring the implementation plan.

Of importance still, is the ability to be aware of the processes involved in the operation room. The surgical checklist makes it possible for surgical teams to be cohesive in the execution of medical functions (Hurlbert and Garrett, 2009). The checklist enables them to function collaboratively and with great efficiency. In reference to this, a monitoring process would involve assessment of the degree to which surgical members are able to understand the processes in the operating room, as well as the level of collaborative efforts in the process.

The way(s) in which a theory of planned change was used to develop the implementation plan

Indeed, the theory of planned change was used in the development of the implementation plan. In reference to the theory of planned behavior, the implementation plan seeks to understand the behavioral traits of the surgical team members while in the operating room.

According to the theory, a person’s attitude and perceptions towards a phenomenon affect his or her behavior towards it (Young-Xu et al., 2011).Therefore, the
implementation plan seeks to grasp the individual perceptions in the usage of the surgical checklist, and determine ways of improving its usage in the operating room. In essence, the premise of this argument is that the inconsistent use of the surgical checklist stems from individual perceptions and attitudes among the surgical personnel. Therefore, the change brought by the implementation plan will come from the capacity of the medical practitioners to change the perceptions that inhibit the consistent use of the surgical checklist.

The feasibility of the implementation plan

The implementation plan is highly feasible because it is evident that there are inconsistencies existing in hospitals in respect to the use of the surgical checklist. The flaws and complications arising from the failure to use the checklist properly necessitate the retraining on the implementation of the AORN surgical checklist. The mortality levels and decreasing safety quality in surgical health settings validates the implementation plan.

Moreover, the implementation plan is a viable solution to the problems mentioned above. The implementation of the plan is imperative in raising the standards of safety among surgery patients and enhancing the effectiveness of surgical teams. Thus, training the surgical personnel on the fundamentals of the patient safety and the need to practice professionalism in work is certainly feasible in solving the looming problems. In reference to the practicality and results oriented nature of the implementation plan, it is definitely a feasible solution.

II. Evaluation Plan

Outcome measure

Conducting a survey is an outcome measure that can establish the extent to which the objectives of the project are achieved. Outcome measures are imperative in assessing the progress and functionality of a proposed solution (Tichansky, 2012). The survey will involve the participants in the proposed implementation plan. The participants in the proposed implementation will give feedback on the implementation process, and consequently, the information gathered will measure the outcomes of the process. In order to measure the outcome of the implementation plan, the information has to go through an evaluation process.

The outcome measure is feasible in a number of ways. It is valid because it involves the active participants in the process. In essence, it derives information from the subjects in the implementation plan. The measure is also reliable because the information gathered for evaluation is dependable and in line with the proposed implementation. There is no distortion of information. The outcome measure is also sensitive to change because of the expansive and dynamic feedback from the participants in the implementation plan.

The dynamic approach of the outcome measure makes it appropriate for the proposed project.

Evaluation Date Collection

The data collection methods for the outcome measure are questionnaires and interviews. The use of questionnaires will require the surgical team members to answer questions concerning the implementation of the plan, and its effects on the surgical process. Interviews will also play a good role in evaluating the implementation process. This involves one on one sessions will the surgical team members on the progress of the plan. The rationale for using these methods is that they give feedback easily and they are pivotal in gathering qualitative data. The dynamic qualitative views from the respondents justify the methods used.

The resources needed for evaluation include finances for conducting the survey and data collection. The finances are for facilitating the evaluation and analysis processes. Apart from the financial resource, the evaluation also needs human resources. The surgical team and hospital leadership are fundamental resources in ensuring a successful evaluation process. The surgical team members give feedback on the implementation of the surgical checklist, while the leadership facilitates the process.

The evaluation plan is feasible as it captures information from the relevant people using the most viable methods. The evaluation plan is reliable since it involves the surgical team members who form a huge role in the implementation process. Moreover, the validity of the process stems from the results-orientated nature of the evaluation plan. The objectives of the evaluation and expected goals are in line with the evaluation plan. A successful evaluation plan unearths the progress of the implementation plan, and gives a viable framework for future actions (Weiser et al., 2011). Hence, the evaluation plan is feasible in determining the degree of the implementation plan.

The two possible grant funding sources would be the government and the WHO. The sources are a good fit for the proposal because the promotion of health care is a major policy by the sources. Governmental health institutions and WHO have continually advocated for improved ways of maintaining patient safety and encouraging medical practitioners to provide their services with utmost proficiency (Wicker & Neill, 2006). Effective surgical operation is a major goal of these sources; hence, the proposal would be a good fit for the sources as they seek to maintain high health standards in the health care arena.

III. Decision Making

Methods and specific plans to maintain a successful project solution

Maintaining a successful plan calls for effective and practical steps towards achieving the goal. Collaborative efforts and leadership are significant methods of maintaining a project solution. The methods are instrumental in bringing the resources needed for the project solution together, and fostering a successful implementation. Collaborative efforts can be maintained by enhancing team work among the surgical team members and enhancing effective communication networks for the project solution.

Team work is an important component in the development of quality health care standards among medical practitioners (Klei et al., 2012). Moreover, maintaining a successful project solution plan deems it necessary to have effective coordination strategies to ensure that the implementation achieves its objectives. It is also significant to foster a culture of patient quality and professionalism among the surgical team members to maintain a successful implementation.

Methods and specific plans to extend a successful project solution

Offering training and education opportunities for the medical practitioners is a feasible method of extending a successful project solution. Training enables surgical professionals to maintain patient safety in the operating room (Norton and Rangel, 2010). Effective training is important in the implementation of the surgical checklist in the operation room. In addition, supporting the implementation plan is vital in extending a successful project solution. This implies that consistency in the implementation plan is highly critical. Inconsistencies in the use of the surgical checklist in the operating room have resulted into the flaws and complications that jeopardize patient safety (Tsai, Boussard, Welton and Morton, 2010).Therefore, identifying barriers to the effective implementation of the plan and offering the required training is valuable in the extending a successful project solution.

Methods and specific plans to revise an unsuccessful project solution

Revising an unsuccessful project solution calls for the hospital leadership to identify the challenges to its implementation. Identifying the barriers to the implementation of a project solution is critical in modifying the plans. Effective monitoring and evaluation is important in the revision of an unsuccessful project solution. In case the project does not achieve the desired goals and objectives, monitoring and evaluation of the progress is essential in forging a viable framework for the modification. Furthermore, training the members involved in the project solution on other platforms of meeting their goals and objectives is indeed a viable plan in revising an unsuccessful project solution. Essentially, revising a project solution requires a critical evaluation of the project and devising feasible mechanisms of making it work.

Methods and specific plans to terminate an unsuccessful solution

Terminating an unsuccessful solution implies that the project has not met the intended objectives and goals. This means withdrawing the resources and tools that were used in the implementation of the solution. Terminating an unsuccessful solution deems it necessary to venture into another project and focus on other goals and objectives. This requires setting objectives and goals with a more detailed focus and deliberate actions (Lingard et al., 2008). The failures of the unsuccessful solution are adequately addressed to avoid a replica of the same in future project solutions. Hence, terminating an unsuccessful project solution calls for an evaluation of its weaknesses and designing a feasible transition program. Effective leadership is needed in terminating an unsuccessful solution and developing efficient project solutions in the future.

Plans for feedback in the work setting and for communicating the project and its results to professional groups external to the project

Feedback in the work setting is extremely important in the implementation of the project solution. The surgical team members have an obligation to enhance team work and collaborate effectively in the work setting in order to foster the required feedback level. Appraisals are also vital means of developing feedback and communication in the work setting. Implementing a constant use of the surgical checklist improves the communication among surgical members in the operating room (Ignatavicius, 2013). Communicating the project and its results to professional groups external to the project involves the use of newsletters and official website. These are feasible ways of communicating to external groups because it is an official form of communication. It is certain that effective feedback and communication platforms are important in the successful implementation of project solutions.


  • Baumer, C. L., Fuller, J. R., Wright, N. H., & Milligan, J. A. (2005). Workbook to accompany surgical technology: principles & practice (4th ed.). St. Louis, Mo: Elsevier Saunders.
  • Bell R, Pontin, L. (2010). How implementing the surgical safety checklist improved staff teamwork in theatre.
    Nursing Times.5(12):12.
  • Byers, J. F., & White, S. V. (2004). Patient safety principles and practice. New York: Springer.
    Conley, D.M., Singer, S.J., Edmondson, L., Berry, W.R. and Gawande, A.A (2011). Effective Surgical Checklist Safety Implementation. Journal of American College of Surgeons, 212 (5)