Implementation of a Surgical Safety Checklist and Postoperative Outcomes: a Prospective Randomized Controlled Study

Abstract

The implementation of a surgical safety checklist is said to minimize postoperative surgical complications. However, to our knowledge, no randomized controlled study has been done on the influence of checklists on postoperative outcomes in a developing country. We conducted a prospective randomized controlled study with parallel group study design of the implementation of WHO surgical safety checklist involving 700 consecutive patients undergoing operations in our hospital between February 2012 and April 2013. In 350 patients, the checklist was implemented with modifications-the Rc arm. The control group of 350 patients was termed the Rn arm. The checklist was filled in by a surgery resident, and only the participants in the study were blinded. Postoperative wound-related (p = 0.04), abdominal (p = 0.01), and bleeding (p = 0.03) complications were significantly lower in the Rc compared to the Rn group. The number of overall and higher-grade complications (Clavien-Dindo grades 3 and 4) per patient reduced from 0.97 and 0.33 in the Rn arm to 0.80 and 0.23 in the Rc arm, respectively. A significant reduction in mortality was noted in the Rc arm as compared to the Rn arm (p = 0.04). In a subgroup analysis, the number of overall and higher-grade complications per patient with incomplete checklists was higher than that with fully completed checklist group. Implementation of WHO surgical safety checklist results in a reduction in mortality as well as improved postoperative outcomes in a tertiary care hospital in a developing country.

A ‘paperless’ wall-mounted surgical safety checklist with migrated leadership can improve compliance and team engagement

“…We believe the findings of this study are important because there is substantial evidence suggesting that the use of the WHO Surgical Safety Checklist (or similar variants) can improve postsurgical outcomes1–5 8 but does not always do so 9. One likely reason for failure to improve outcomes is inadequate engagement with the use of the checklist;10 and improvement in outcome also seems to be related to completeness of checklist administration 2–5.…”

Segurança do paciente: caracterização de vídeos do YouTube

“…A study carried out in India showed that the implementation of a modified checklist on surgical safety was associated with decrease in mortality and in the number of complications. Mortality was significantly lower when this checklist was implemented (18) . A study conducted in Taiwan on the administration of chemotherapeutic drugs also revealed that the lack of pro-tocols and lack of knowledge of health professionals were the main causes of adverse events, and an intervention consisting in the implementation of protocols significantly reduced medication errors (19) .…”

Segurança do paciente: investigação fenomenológica de um grupo de pesquisa

“…Um estudo realizado na Índia que teve por escopo avaliar a aplicação de um checklist de cirurgia segura denotou que a implementação de uma lista de verificação da OMS modificada sobre segurança cirúrgica foi associada a uma diminuição da mortalidade e ao número de complicações. A mortalidade foi significativamente menor no grupo em que esta lista foi usada em comparação ao grupo em que não foi (10 vs 5,7%; p = 0,04) (24) . Uma investigação realizada no Taiwan sobre administração de medicamentos quimioterápi-cos também revelou que a falta de protocolos e o subjacente conhecimento deficiente dos profissionais foram as principais causas de eventos adversos, sendo que a intervenção com a implantação de protocolos trouxe uma diminuição significativa dos erros de medicações (25) .…”