Surgical checklist 'saves lives'

Article on BBC website 14 January 2009.

A one-page checklist devised by the World Health Organization (WHO) has been tested in eight cities around the globe (Seattle, Toronto, London, Auckland, Amman, New Delhi, Manila and Ifakara, Tanzania). It focuses on basic good practice before anaesthesia is administered, before a patient is cut open, and before a patient is removed from the operating theatre, and is designed to promote effective teamwork and prevent problems such as infection and unnecessary blood loss.

Data was collected from 7,688 patients, 3,733 before the checklist was implemented, and 3,955 afterwards. The rate of major complications fell from 11% to 7%, and the rate of inpatient deaths following surgery fell more than 40% from 1.5% to 0.8%. Findings were similar across all the hospitals in the study.

Dr Alex Haynes, who led the study, said the checklist had a significant impact at every hospital site in the study. "Even many clinicians who were initially sceptical of the idea became advocates once they saw the benefits to safety and consistency of care."

Dr Kevin Cleary, NPSA medical director, said: "The results of the study give clear evidence that a simple intervention leads to dramatic improvement in outcome for patients undergoing surgery."

UK Health Minister Lord Darzi is quoted as saying "The beauty of the surgical safety checklist is its simplicity" and "Operating theatres are high-risk environments. By using the checklist for every operation we are improving team communication, saving lives and helping ensure the highest standard of care for our patients."

The checklist is already in use in Scotland and the National Patient Safety Agency (NPSA) has ordered all hospitals in England and Wales to use it across the board by February 2010.

I'm a strong advocate of checklists for certain tasks, although their overuse can be counter-productive. What I don't understand is why it will take so long to get this implemented. The checklist is readily available for use. You can download it from the BBC website.

Andy Brazier