Simple Surgical Checklist Saves Lives

A simple surgical safety checklist reduced patient-mortality and complications by more than a third, according to a new study in the New England Journal of Medicine.

The 19-item checklist, developed by the World Health Organization is pretty straightforward. At various points during the surgical procedure, team members must confirm they’re doing the right thing on the right part of the right patient and that they’re prepared for high-risk situations that may arise and that key issues regarding post-op are clear.

The rate of serious complications fell from 11 to 7 percent during the one-year pilot study, led by Dr. Atul Gawande, which involved about 8,000 patients. Overall, patient deaths declined by more than 40 percent when the checklist was introduced, from 1.5 percent to 0.8 percent, the researchers found.

If all hospitals were to use the same checklist, they could save tens of thousands of lives and $20 billion in medical costs annually, says Gawande.

An estimated 234 million surgeries are performed worldwide each year, with between 3 to 17 percent resulting in major complications such as a life-threatening infection. In the U.S. the average surgical complication can cost upwards of $12,000 to treat, though as many as half are preventable, according to several studies that span the past 15 or so years.

Included on the 19-item checklist is: checking anesthesia, sterile equipment and drugs, blood supply, double-checks of the site to be operated on and verbal roll call of the surgical team.

"Surprisingly, the concept of using a simple yet comprehensive checklist is a rather new concept to us in surgery. Not everyone was happy to try it," Gawande said.

"But the results were remarkable. And the teams became strong supporters."

The U.K.’s National Health Service sent an alert to all hospitals calling on them to use the checklist, as a result of the findings. So far, five U.S. states – Indiana, New York, North Carolina, South Carolina and Washington – have endorsed the surgical checklist and plan to require that hospitals use it. #