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Surgical Safety Checklist


Below content is taken from the New England Journal's 2009 article "A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population"

In 2008, the World Health Organization (WHO) published guidelines identifying multiple recommended practices to ensure the safety of surgical patients worldwide. On the basis of these guidelines, a team of healthcare experts designed a 19-item checklist intended to be globally applicable and to reduce the rate of major surgical complications. The Surgical Safety Checklist Team hypothesized that implementation of this checklist and the associated culture changes it signified would reduce the rates of death and major complications after surgery in diverse settings.

Results of the Intervention

The study enrolled 3733 patients during the baseline period and 3955 patients after implementation of the checklist. The following was found:-

  • The rate of any complication at all sites dropped from 11.0% at baseline to 7.0% after introduction of the checklist 
  • The total in-hospital rate of death dropped from 1.5% to 0.8%
  • The overall rates of surgical-site infection and unplanned reoperation also declined significantly 
  • Rates of complication fell from 10.3% before the introduction of the checklist to 7.1% after its introduction among high-income sites and from 11.7% to 6.8% among lower-income sites 
  • The rate of death was reduced from 0.9% before checklist introduction to 0.6% afterward at high-income sites and from 2.1% to 1.0% at lower-income sites
  • In the cross-validation analysis, the effect of the checklist intervention on the rate of death or complications remained significant after the removal of any site from the model. We also found no change in the significance of the effect on the basis of clustering .

Case in  Detail

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