Research backs surgical check-list

Thursday January 15th, 2009

Introducing a simple check-list for surgical operations can reduce complications by as much as a third, a major international study revealed today.

The check-list procedure has been tested in hospitals in London as well as in India, Philippines, Tanzania, USA, Canada and New Zealand.

A World Health Organisation analysis shows that rates of major complications fell from 11 per cent to seven per cent after introducing a check-list.

Patient deaths in hospital fell from 1.5 per cent to 0.8 per cent, the researchers report in the New England Journal of Medicine.

The analysis involved studying results for some 7,688 patients, about half before check-lists were implemented and about half afterwards.

The check-list is used at three points during the operation, before anaesthesia, before skin incision and before the patient leaves the operating theatre.

Researcher Dr Atul Gawande, of Harvard University, Massachusetts, USA, said: "The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery. Not everyone on the operating teams were happy to try it.

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

The British chief medical officer, Professor Sir Liam Donaldson, who chairs a WHO group on patient safety, said: "The immediate response to the checklist has been remarkable, and the studies undertaken in the pilot hospitals are significant.

"They will make a major contribution towards our goal of having 2,500 hospitals around the world using the safe surgery checklist by the end of this year."

"A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population," (N Engl J Med 2009;360:491-9)

Tags: Asia | General Health | North America | UK News | World Health

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