Study
shows checklist reduces adverse effects by one third
By Matt Gunn
News Editor/Writer
By Matt Gunn
News Editor/Writer
A series of recent studies showed the use of a simple surgical checklist has the potential to reduce adverse effects and surgery-related death by as much as one-third.
Eight hospitals located in each of the World Health Organization's (WHO's) six global regions participated in the study by using a simple surgical checklist developed by the WHO. Part of the Safe Surgery Saves Lives initiative started last year, the Surgical Safety Checklist is a simple set of surgical operating room standards that can be applied to any facility's operation.
"The immediate response to the checklist has been remarkable, and the studies undertaken in the pilot hospitals are significant," Sir Liam Donaldson, Chair of the WHO World Alliance for Patient Safety and Chief Medical Officer for England, said in a release. "They will make a major contribution towards our goal of having 2500 hospitals around the world using the safe surgery checklist by the end of this year."
Participating hospitals collected data from 7,688 patients. Of that group, patient data from 3,700 patients was collected before facilities implemented the Surgical Safety Checklist, while data from the remaining 3,955 patients was collected after implementation.
All told, analysis of these data showed major complications dropped one third - from 11% before checklist implementation to 7% after it was introduced. Inpatient deaths made a dramatic 40% reduction with checklist implementation.
The study was conducted by the Harvard School of Public Health and published online Jan. 14 by The New England Journal of Medicine.
AORN has supported the WHO in creating and promoting the Surgical Safety Checklist.
"AORN supports the use of the check list as it is consistent with all our efforts to make surgery safe," said AORN CEO Linda Groah, RN, MSN, CNOR, FAAN. The checklist covers all the critical issues that must be reviewed in three phases of surgical intervention: prior to induction of anesthesia, before the skin incision is made and before the patient leaves the operating room. AORN has supported the use of a checklist to assist the surgical team to make sure that all the important aspects of care are completed - we know through the human factors training that we support that on any day on any case one of the important items may be forgotten a the outcome to the patient can be devastating. Now we have the results of the 8 pilot sites to provide evidence that the checklist can make a difference and result in safer surgery for our patients."
The use of a checklist is standard procedure in the airline industry, where it is designed to prevent pilots and technicians from overlooking elements crucial to safety prior to taking off.
"The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery," said Atul Gawande, MD, main author of the study and team leader for the development of the WHO surgical safety checklist. "Not everyone on the operating teams were happy to try it. But the results were unprecedented. And the teams became strong supporters."
A WHO video on how to do the Surgical Safety Checklist is available here. Find the WHO checklist and more information on the Safe Surgery Saves Lives campaign here.
"OR Directors and managers can use the results of this study to demonstrate to members of their team that the checklist is an important adjunct to other measures they may have implemented along with the universal protocol to enhance the care they are providing to their patients," Groah said. "Surgeons and anesthesiologist frequently request data to demonstrate why new procedures are being introduced and nursing management now has the support for their request to implement a check list."
Read more news in AORN Management Connections.
Eight hospitals located in each of the World Health Organization's (WHO's) six global regions participated in the study by using a simple surgical checklist developed by the WHO. Part of the Safe Surgery Saves Lives initiative started last year, the Surgical Safety Checklist is a simple set of surgical operating room standards that can be applied to any facility's operation.
"The immediate response to the checklist has been remarkable, and the studies undertaken in the pilot hospitals are significant," Sir Liam Donaldson, Chair of the WHO World Alliance for Patient Safety and Chief Medical Officer for England, said in a release. "They will make a major contribution towards our goal of having 2500 hospitals around the world using the safe surgery checklist by the end of this year."
Participating hospitals collected data from 7,688 patients. Of that group, patient data from 3,700 patients was collected before facilities implemented the Surgical Safety Checklist, while data from the remaining 3,955 patients was collected after implementation.
All told, analysis of these data showed major complications dropped one third - from 11% before checklist implementation to 7% after it was introduced. Inpatient deaths made a dramatic 40% reduction with checklist implementation.
The study was conducted by the Harvard School of Public Health and published online Jan. 14 by The New England Journal of Medicine.
AORN has supported the WHO in creating and promoting the Surgical Safety Checklist.
"AORN supports the use of the check list as it is consistent with all our efforts to make surgery safe," said AORN CEO Linda Groah, RN, MSN, CNOR, FAAN. The checklist covers all the critical issues that must be reviewed in three phases of surgical intervention: prior to induction of anesthesia, before the skin incision is made and before the patient leaves the operating room. AORN has supported the use of a checklist to assist the surgical team to make sure that all the important aspects of care are completed - we know through the human factors training that we support that on any day on any case one of the important items may be forgotten a the outcome to the patient can be devastating. Now we have the results of the 8 pilot sites to provide evidence that the checklist can make a difference and result in safer surgery for our patients."
The use of a checklist is standard procedure in the airline industry, where it is designed to prevent pilots and technicians from overlooking elements crucial to safety prior to taking off.
"The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery," said Atul Gawande, MD, main author of the study and team leader for the development of the WHO surgical safety checklist. "Not everyone on the operating teams were happy to try it. But the results were unprecedented. And the teams became strong supporters."
A WHO video on how to do the Surgical Safety Checklist is available here. Find the WHO checklist and more information on the Safe Surgery Saves Lives campaign here.
"OR Directors and managers can use the results of this study to demonstrate to members of their team that the checklist is an important adjunct to other measures they may have implemented along with the universal protocol to enhance the care they are providing to their patients," Groah said. "Surgeons and anesthesiologist frequently request data to demonstrate why new procedures are being introduced and nursing management now has the support for their request to implement a check list."
Read more news in AORN Management Connections.