Study: Fewer post-surgery deaths with use of safety checklist
- Post-surgical deaths at South Carolina hospitals dropped 22% after implementation of the World Health Organization’s Surgical Safety Checklist.
- The state is the first in the U.S. to implement the checklist statewide, according to Ariadne Labs, which collaborated with the South Carolina Hospital Association and Harvard T.H. Chan School of Public Health on a five-year pilot project.
- Post-surgery mortality in hospitals that completed the program fell from 3.38% in 2010, before implementation, to 2.84% in 2013, compared with 3.5% and 3.71%, respectively, for hospitals that didn’t adopt the checklist.
All hospitals in the state were invited to participate in the Safety Surgery South Carolina program, which involved a 12-step implementation program wherein hospitals customized the checklist for the local setting. Fourteen chose to participate and 44 did not. The difference in mortality rates between the two groups was 22%, results of the project show.
“That is a major reduction in post-surgical mortality and it demonstrates that when done right, the Surgical Safety Checklist can significantly improve patient safety at large scale,” lead author Alex B. Haynes, associate director of the Ariadne Labs Safety Program and a surgeon at Massachusetts General Hospital, said in a statement.
The South Carolina project could serve as a model for other states on best practices for establishing a team-based communication checklist to improve quality and outcomes in the operating room, the study suggests. The study, currently online, will publish in the August 2017 issue of Annals of Surgery.
A team of experts led by Ariadne Labs Executive Director Atul Gawande developed the 19-item WHO Surgical Safety Checklist in 2008. In November, WHO released guidelines aimed at reducing surgical infections and hospital-associated superbugs. The 29 recommendations include 13 for the presurgical period and 16 for during and after surgery.
For example, WHO recommends that people preparing for surgery should shower or bathe, and that hair should not be removed from the operative site unless necessary to perform the procedure. The group also recommends using antibiotics before and during surgery, but not after.
Surgical site infections result in 400 additional hospital days and $900 million in extra costs annually, according to WHO.