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Home / Equine Research Bank / Equine Vet J / Clinical audit of pre-procedural checklists in an equine ref...
Equine veterinary journal2025; doi: 10.1111/evj.70097

Clinical audit of pre-procedural checklists in an equine referral hospital.

Abstract: Surgical safety checklists have demonstrated a positive impact on post-surgical morbidity/mortality in human medicine, and likely have an equal benefit in veterinary medicine. To realise their advantages, they must be correctly and regularly used. A clinical audit was planned to assess this. Objective: To determine the compliance with the pre-procedural request form/surgical safety checklist in a large multi-disciplinary equine referral hospital. Methods: Retrospective full-cycle clinical audit. Methods: One hundred and forty-eight checklists (consisting of 23 sub-sections) were examined for completeness. Descriptive statistics were calculated, and section completion rates were compared against national standards. Interventions to improve checklist use were made: a checklist redesign after consultation with end-users, a hospital education scheme to improve staff understanding, regular e-mail reminders, and recruitment of key senior staff as champions. Lastly, it was made policy for checklists to be uploaded to the horse's medical record. Following this, 30 new checklists were re-audited in the same manner. Results obtained were compared against the first audit and national standards. Results: Checklists were rarely fully complete. In the first audit, completion rates for various subsections ranged from 9% to 89%, with a median value of 64%. In the re-audit, the completion rates ranged from 80% to 100%, with a median value of 93%. The sign-out section was most likely to be incomplete. Conclusions: Data were not collected in real-time, and it is difficult to determine the significance of missing data. Staff were aware of the re-audit; it is possible that checklist compliance was temporarily increased. Fewer checklists were examined in the second audit. Conclusions: The interventions have a positive benefit on checklist completion. A clinical audit of checklists is a useful tool that can easily be conducted in practice and may help promote a safety culture within hospitals.
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Publication Date: 2025-09-05 PubMed ID: 40908902DOI: 10.1111/evj.70097Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study audited how well pre-procedural surgical safety checklists were used in a large equine referral hospital.
  • It evaluated checklist completion rates before and after targeted interventions aimed at improving their use.

Background and Objective

  • Surgical safety checklists have been proven to reduce complications and mortality in human surgeries.
  • Similar benefits are expected in veterinary surgeries, but the effectiveness depends on regular and correct use of checklists.
  • The audit aimed to determine compliance with the pre-procedural request forms and surgical safety checklists in a multidisciplinary equine hospital.

Methods

  • A retrospective audit was conducted examining 148 checklists, each with 23 sub-sections.
  • Completeness of each checklist and its subsections were assessed and compared to national standards for checklist completion.
  • Interventions implemented to improve checklist use included:
    • Redesigning the checklist after consulting with staff who use them.
    • Staff education programs to enhance understanding of checklist importance.
    • Regular email reminders to staff to encourage checklist completion.
    • Recruitment of senior staff champions to promote adherence and culture of safety.
    • Making checklist upload to the horse’s medical record a hospital policy.
  • After interventions, a re-audit was conducted on 30 new checklists to assess improvements.

Results

  • Initial audit findings:
    • Checklist completion rates varied widely from 9% to 89% across different subsections.
    • The median completion rate was 64%, indicating many checklists were incomplete.
    • The sign-out section was most frequently left incomplete.
  • Re-audit findings after interventions:
    • Completion rates improved significantly, ranging from 80% to 100% per subsection.
    • The median completion rate rose to 93%, showing a positive impact from interventions.

Conclusions and Limitations

  • The audit demonstrated that targeted educational and procedural interventions can significantly improve checklist adherence in an equine veterinary setting.
  • Checklists remain a useful tool not only to guide clinical practice but also to foster a culture of safety and accountability in veterinary hospitals.
  • Limitations include:
    • Data was collected retrospectively, so it is unclear how missing data affected clinical outcomes.
    • Staff awareness of the re-audit might have temporarily improved compliance (Hawthorne effect).
    • The number of checklists examined in the re-audit was smaller (30 versus 148), which might affect robustness of results.
  • Despite these limitations, regular clinical audits of checklist use are practical and valuable in veterinary clinical practice.

Cite This Article

APA
Beeston TJ, Duncan JC, Pollock PJ. (2025). Clinical audit of pre-procedural checklists in an equine referral hospital. Equine Vet J. https://doi.org/10.1111/evj.70097

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Beeston, Thomas J
  • Royal (Dick) School of Veterinary Studies Equine Hospital, University of Edinburgh, Edinburgh, UK.
Duncan, Juliet C
  • Royal (Dick) School of Veterinary Studies Equine Hospital, University of Edinburgh, Edinburgh, UK.
Pollock, Patrick J
  • Royal (Dick) School of Veterinary Studies Equine Hospital, University of Edinburgh, Edinburgh, UK.

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