Surgery Checklist Linked to Lower Complications, Mortality

Safety checklist required input from variety of personnel; hospitals had high standard of care

WEDNESDAY, Nov. 10 (HealthDay News) -- The use of a comprehensive, multidisciplinary surgical safety checklist in hospitals that already have a high standard of care appears to be associated with fewer surgical complications and lower mortality, according to research published in the Nov. 11 issue of the New England Journal of Medicine.

Eefje N. de Vries, M.D., of the Academic Medical Center in Amsterdam, Netherlands, and colleagues analyzed data from six hospitals (with high standards of care) that implemented a surgical safety checklist that included medications, marking the operative site, and postoperative instructions and required completion by the ward doctor, surgeon, nurse, operating assistant, and anesthesiologist. The researchers compared complication rates during a three-month baseline period and a three-month period after implementation, and collected similar data from five control hospitals.

The researchers found that complications fell from 27.3 to 16.7 per 100 patients. The proportion of patients with one or more complications fell from 15.4 to 10.6 percent. In-hospital mortality fell from 1.5 to 0.8 percent. In the control hospitals, outcomes remained unchanged.

"Although some questions remain, surgical checklists should be considered a priority for providers, payers, and policymakers," writes the author of an accompanying editorial. "The Joint Commission is positioned to accelerate the adoption of surgical checklists. Payers could provide incentives for the use of checklists through their pay-for-performance programs instead of continuing to focus on hospital compliance with a small number of specific processes of care."

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