Dental News - Checklist reduces surgical issues

Daniel Zimmermann, DTI

Thu. 22. January 2009

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Hospitals in eight cities around the globe have successfully demonstrated that the use of a simple surgical checklist, developed by World Health Organization (WHO), during major operations can lower the incidence of surgery-related deaths and complications by one third.

Analysis shows that the rate of major complications following surgery fell from 11 per cent in the baseline period to 7 per cent following the introduction of the checklist, a reduction of one third. Inpatient deaths following major operations fell by more than 40 per cent (from 1.5 per cent to 0.8 per cent).

The checklist, which was introduced by the WHO as a recommended guideline for safe practice last year, has since gained global recognition by operating theatre staff. WHO officials said that it is intended to ensure the safe delivery of anaesthesia, appropriate prophylaxis against infection, effective teamwork by the operating room staff, and other essential practices in perioperative care.

“The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery,” said Dr Atul Gawande, main author of the study and team leader for the development of the WHO surgical safety checklist. “Not everyone on the operating teams was happy to try it. But the results were unprecedented. And the teams became strong supporters.”

Pilot studies were undertaken in hospitals in each of the six WHO regions and carried out in both high and lower income settings. In Asia, hospitals in Manila in the Philippines, New Delhi in India, and Auckland in New Zealand took part in the study. Data was collected from 7,688 patients.

“These findings have implications beyond surgery, suggesting that checklists could increase the safety and reliability of care in numerous medical fields,” Dr Gawande added. “The checklists must be short, extremely simple, and carefully tested in the real world. But in specialties ranging from cardiac care to paediatric care, they could become as essential in daily medicine as the stethoscope.”

“The immediate response to the checklist has been remarkable, and the studies undertaken in the pilot hospitals are significant. They will make a major contribution towards our goal of having 2,500 hospitals around the world using the safe surgery checklist by the end of this year,” said Sir Liam Donaldson, Chair of the WHO World Alliance for Patient Safety and Chief Medical Officer for England.

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