Évaluation et applicabilité de la check-list HAS au quotidien: expérience des centres de lutte contre le cancer

Introduction: The use of WHO checklist has been associated to a decrease of complication incidence and mortality. This control is mandatory since January the 1st 2010. Evaluation of the quality of documentation is important and includes filling rate, which is a reflexion of participant adhesion and analysis of the circumstances where the team answers "no" during the control. Methods: This study concerned 17 among 20 French cancer centres. Percentage of documented checklist, exhaustivity of the answers in each checklist and "no" answers have been compared during two periods: January 2010 and October 2010. Results: Rate of filled document is satisfactory and stable during the two periods (95.5% versus 95.8%). Exhaustivity was slightly better during the second period (64 and 68%, P = 0,039). Nevertheless, variability between centres was large; one centre improved and four centres worsened their scores. Rate of "no" answers was low and increased during the second period (1.5% in January 1.9% in October P< 0.001). They mainly concerned antibiotic administration and at a lesser degree bleeding risk, the name of the procedure, equipment problem to be addressed and postoperative management. Discussion: There is a large discrepancy between centres and for a given centre in reporting quality. Significant progress should be expected using target improvement. This approach implies multiple critical analysis of checklist content in each hospital and in multicentre enquiries.