In a UK study, use of surgical safety checklist led to lower complication rates only when it was fully completed.Ann Surg. 2015 Mar 13; [Epub ahead of print].
Surgical checklist implementation project: the impact of variable WHO checklist compliance on risk-adjusted clinical outcomes after national implementation: a longitudinal study.
Mayer EK, Sevdalis N, Rout S, et al. Ann Surg. 2015 Mar 13; [Epub ahead of print].The remarkable initial success of the World Health Organization surgical safety checklist led to the United Kingdom's National Health Service mandating its use in 2009. Subsequent studies of the checklist, however, have failed to demonstrate improvements in perioperative complication rates. This study analyzed the relationship between checklist implementation and complication rates at five hospitals in the UK. The investigators found that the checklist was effective only when it was fully completed—the odds of a postoperative complication were reduced by more than 40% if the full checklist was completed, but this was done in only 62% of cases. Moreover, even complete checklist usage did not seem to prevent complications in low-risk patients. The results of this and other studies clearly demonstrate that a checklist is a complex intervention that requires rigorous implementation and monitoring in order to improve safety.
Cutting out human error.
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An evaluation of information transfer through the continuum of surgical care: a feasibility study.
Nagpal K, Vats A, Ahmed K, Vincent C, Moorthy K. Ann Surg. 2010;252:402-407.
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Anderson O, Davis R, Hanna GB, Vincent CA. Am J Surg. 2013;206:253-262.
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A qualitative study comparing experiences of the surgical safety checklist in hospitals in high-income and low-income countries.
Aveling EL, McCulloch P, Dixon-Woods M. BMJ Open. 2013;3:e003039.