WHO creates new surgical checklist

Campaign meant to prevent needless complications and deaths during surgeries throughout the world.

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June 24, 2008 22:50
2 minute read.
WHO creates new surgical checklist

doctor 88. (photo credit: )

A new safety checklist for surgical teams to use in operating theaters - requiring them to confirm that they have carried out the necessary stages including counting needles, sponges and instruments - has been launched by the World Health Organization around the globe. The campaign, to be announced on Wednesday in Geneva, is aimed at preventing needless complications and deaths during surgery. More than 234 million surgical procedures are carried out worldwide each year. The checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work - before induction of anesthesia, before skin incision and before the patient leaves the operating room. In each phase, a checklist coordinator must be allowed to confirm that the team has completed its tasks before it proceeds with the operation. For example, before the first incision, the surgical site must be marked and the patient's known allergies must be checked, and before being sewn up, all implements used must be counted. But about two years before the WHO announced these safety measures, quality-control experts at Hadassah University Medical Center in Jerusalem and at the Technion-Israel Institute of Technology in Haifa had already developed a protocol, which appears on walls in operating rooms and in notebooks to be studied by doctors, nurses and technicians before the patient is put under anesthesia. The pre-operative briefing, which occurs when all staffers are present and the patient is awake, has been shown to significantly reduce errors and complications in patients and is due to be published in a foreign medical journal. After being studied for its effects by surgeons, nurses and department heads, the briefings were quickly adopted as routine at Hadassah, as they were found to be so effective. Prof. Yoel Donchin, a senior anesthesiologist and head of Hadassah's patient safety unit, told The Jerusalem Post that the briefings resulted in an overall 21 percent decrease in the number of "critical events" (irregularities or deviations from good performance) and a 15% increase in the number of surgeries performed without any such event. Team members said the briefings were "highly valuable" in performing their individual tasks and increasing patient safety and willingly agreed to participate. "Preventable surgical injuries and deaths are now a growing concern," said WHO director-general Dr. Margaret Chan. "Using the checklist is the best way to reduce surgical errors and improve patient safety." Several studies have shown that in industrial countries major complications are reported to occur in three percent to 16% of inpatient surgical procedures, with permanent disability or death rates of approximately 0.4% to 0.8%. In developing countries, death rates range between 5% and 10 % during major surgery. About half of these complications can be prevented. The Safe Surgery Saves Lives initiative is a collaborative effort led by the Harvard School of Public Health and involves more than 200 national and international medical societies and ministries of health in a effort to meet the goal of reducing avoidable deaths and complications in surgical care. Now, the WHO Surgical Safety Checklist identifies a set of surgical safety standards that can be applied in all countries and health settings.


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