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WHO surgical checklist reduces inpatient complication and deaths

Hospitalist Leadership Connection, January 20, 2009

The World Health Organization (WHO) last week released a safe surgery checklist that can reduce adverse events by nearly one third, according to the Jan. 14 WHO press release.

Data came from hospitals in eight countries with 7,688 patients of high-income and low-income status. The study indicated that inpatient deaths after operation dropped by more than 40% (from 1.5% to 0.8%), and inpatient complications fell by one-third (from 11% to 7%).

Described as “simple,” according to the press release, this 19-item checklist developed by WHO only takes a few minutes to implement at three critical times during surgery: (1) before anesthesia; (2) before skin incision; and (3) before the patient leaves the operating room (OR). Using this checklist can prevent infection and streamline teamwork of the OR staff.

"The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery. Not everyone on the operating teams [was] happy to try it,” said Atul Gawande, main author of the study and team leader for the development of the WHO surgical safety checklist in the press release. “But the results were unprecedented. And the teams became strong supporters.”
 
The results of the study, “A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population,” were published in the January issue of the New England Journal of Medicine.

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