Surgical checklist slashes mortality rate

Surgeons who use a simple surgical checklist whilst conducting major procedures can significantly reduce their patients' risk of complications and death, new research suggests.

Seven hospitals around the world were chosen for the study to pilot a Surgical Patient Safety Checklist, devised by the World Health Organization (WHO) as part of their “Safe Surgery Saves Lives” initiative. The checklist, which only takes a few minutes to complete, was designed to improve communication between members of the surgical team at three critical points during surgery – before anesthesia is administered, before a patient is cut open, and before a patient leaves the operating room – with the aim of reducing the risk of complications such as infection and unnecessary blood loss.

Results of the pilot study showed that the incidence of major complications fell by more than one third, from 11% to 7% after surgical teams began using the checklist. Furthermore, the rate of inpatient deaths following surgery fell by more than 40% from 1.5% to 0.8%.

The authors concluded: “Surgical complications are a considerable cause of death and disability around the world. They are devastating to patients, costly to health care systems, and often preventable, though their prevention typically requires a change in systems and individual behavior. In this study, a checklist-based program was associated with a significant decline in the rate of complications and death from surgery in a diverse group of institutions around the world. Applied on a global basis, this checklist program has the potential to prevent large numbers of deaths and disabling complications.”

Haynes AB, Weiser TG, Berry WR, et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. NEJM. January 14th 2009. doi: 10.1056/NEJMsa0810119