Consistency and surgical safety checklists: the key to saving lives

A new study published in The Journal of the American Medical Association  found that 17- to 24-item surgical safety checklists (SSC) both reduce patient stays and lower mortality rates. For the study, researchers examined the cases of 10,700 patients at Bolzano Central Hospital in Italy. They found that six months after SSCs were implemented, mortality rates within 90 days of surgery dropped by 27%. The checklists also lowered the length of hospital stays from 10.4 days to 9.6 days.

 "To our knowledge, this report is the first on the association of SSCs and 90-day all-cause mortality, which might be even more important than 30-day all-cause mortality,” lead author Matthias Bock, MD and colleagues wrote in a press release. “ Thirty-day all-cause mortality might fail to capture intermediate-term complications, such as anastomosis leakage or pulmonary embolism, which occur despite prophylaxis late after trauma or genitourinary and general surgery."

The study came with accompanying commentary by William Berry, MD. The commentary was titled The Surgical Checklist: It Cannot Work If You Do Not Use It, and focused around the need to apply SSCs consistently for them to have an impact.

"A focus on the systems of care and promotion of a culture of safety at the institutional level is necessary to optimize checklist implementation and realize its full potential,” Berry writes. “Effective implementation is critical to meaningful use of SSCs, which can lead to maximally improved outcomes."

Click here for a free book excerpt on the importance of checklists in healthcare.