Surgical Checklist Slashes Complications, Deaths

Nineteen-item checklist almost halves death rate due to non-cardiac surgery
By Jane Parry
HealthDay Reporter

WEDNESDAY, Jan. 14 (HealthDay News) -- Using a 19-item checklist can significantly reduce the rates of death and complications as a result of surgery, according to a report published online Jan. 14 in the New England Journal of Medicine.

Alex B. Haynes, M.D., of the Harvard School of Public Health in Boston, and colleagues analyzed data from patients aged 16 and older who underwent non-cardiac surgery in one of eight hospitals in eight cities: Toronto, Canada; New Delhi, India; Amman, Jordan; Auckland, New Zealand; Manila, Philippines; Ifakara, Tanzania; London, England; and Seattle, Wash. The hospitals were participants in the World Health Organization's Safe Surgery Saves Lives program, and implemented a 19-item checklist for surgical safety. The researchers prospectively analyzed data from 3,733 enrolled patients and subsequently collected data on 3,955 patients after introduction of the checklist.

Before the hospitals implemented the surgical safety checklist, the overall surgical death rate was 1.5 percent, and this dropped to 0.8 percent after implementation, the researchers report. The rate of inpatient complications also fell from 11 percent before implementation to 7 percent after, the investigators found.

"All sites were able to introduce the checklist over a period of one week to one month," the authors write. "Applied on a global basis, this checklist program has the potential to prevent large numbers of deaths and disabling complications, although further study is needed to determine the precise mechanism and durability of the effect in specific settings."

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