No improvement after statewide surgical checklist effort in Michigan; raises questions regarding checklist efficacy in nonresearch settings.
Med Care. 2015;53:87-94.
Evaluation of the effectiveness of a surgical checklist in Medicare patients.
Reames BN, Scally CP, Thumma JR, Dimick JB. Med Care. 2015;53:87-94.
The introduction of surgical safety checklists is often seen as a milestone accomplishment for the patient safety field, based on impressive reductions in mortality and complications shown in early international studies. More recently, a large trial in Ontario failed to show significant improvements following mandatory checklist adoption. However some concerns were raised related to methodological limitations, such as a lack of a comprehensive program for implementation. This study examined the effects of the Keystone Surgery program, a statewide effort in Michigan hospitals to introduce a surgical safety checklist along with acomprehensive unit-based safety program. Using Medicare claims data, no differences were found in adjusted 30-day mortality, complication rates, reoperations, or readmissions for hospitals participating in Keystone Surgery. Unlike the prior Ontario study, this study assessed outcomes up to 3 years following implementation and included a standardized and comprehensive implementation strategy. These results cast further doubt on the power of surgical safety checklists to improve outcomes when implemented in non-research settings.
Doctor uses 'pre-flight' checklist.
Bernhard B. The Orange County Register. April 19, 2006.
Medmarx Data Report: A Chartbook of Medication Error Findings from the Perioperative Settings from 1998-2005.
Rockville, MD: United States Pharmacopeia; 2007.
A surgical safety checklist to reduce morbidity and mortality in a global population.
Haynes AB, Weiser TG, Berry WR, et al; for the Safe Surgery Saves Lives Study Group. N Engl J Med. 2009;360:491-499.
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Effect of a 19-item surgical safety checklist during urgent operations in a global patient population.
Weiser TG, Haynes AB, Dziekan G, et al; Safe Surgery Saves Lives Investigators and Study Group. Ann Surg. 2010;251:976-980.