RESEARCH - A surgical safety checklist to reduce morbidity and mortality in a global population

[Guest guest]

NEJM

Volume 360:491-499 January 29, 2009 Number 5

A Surgical Safety Checklist to Reduce Morbidity and Mortality in a

Global Population

B. Haynes, M.D., M.P.H., G. Weiser, M.D., M.P.H.,

R. Berry, M.D., M.P.H., Stuart R. Lipsitz, Sc.D., Abdel-Hadi S.

Breizat, M.D., Ph.D., E. Patchen Dellinger, M.D., Teodoro Herbosa,

M.D., Sudhir ph, M.S., Pascience L. Kibatala, M.D., Marie Carmela

M. Lapitan, M.D., Alan F. Merry, M.B., Ch.B., F.A.N.Z.C.A., F.R.C.A.,

Krishna Moorthy, M.D., F.R.C.S., K. Reznick, M.D., M.Ed.,

Bryce , M.D., Atul A. Gawande, M.D., M.P.H., for the Safe

Surgery Saves Lives Study Group

ABSTRACT

Background Surgery has become an integral part of global health care,

with an estimated 234 million operations performed yearly. Surgical

complications are common and often preventable. We hypothesized that a

program to implement a 19-item surgical safety checklist designed to

improve team communication and consistency of care would reduce

complications and deaths associated with surgery.

Methods Between October 2007 and September 2008, eight hospitals in

eight cities (Toronto, Canada; New Delhi, India; Amman, Jordan;

Auckland, New Zealand; Manila, Philippines; Ifakara, Tanzania; London,

England; and Seattle, WA) representing a variety of economic

circumstances and diverse populations of patients participated in the

World Health Organization's Safe Surgery Saves Lives program. We

prospectively collected data on clinical processes and outcomes from

3733 consecutively enrolled patients 16 years of age or older who were

undergoing noncardiac surgery. We subsequently collected data on 3955

consecutively enrolled patients after the introduction of the Surgical

Safety Checklist. The primary end point was the rate of complications,

including death, during hospitalization within the first 30 days after

the operation.

Results The rate of death was 1.5% before the checklist was introduced

and declined to 0.8% afterward (P=0.003). Inpatient complications

occurred in 11.0% of patients at baseline and in 7.0% after

introduction of the checklist (P<0.001).

Conclusions Implementation of the checklist was associated with

concomitant reductions in the rates of death and complications among

patients at least 16 years of age who were undergoing noncardiac

surgery in a diverse group of hospitals.

*********************************************************

Read the full article here:

http://content.nejm.org/cgi/content/full/360/5/491

Not an MD