Surgical Safety Checklists and Postoperative Outcomes
Surgical Safety Checklists and Postoperative Outcomes
deVries EN, Prins HA, Crolla RM, et al; SURPASS Collaborative Group
N Engl J Med. 2010;363:1928-1937
How effective is a comprehensive surgical safety checklist in reducing adverse postoperative events? The authors conducted a randomized before-and-after trial in 6 Dutch hospitals where the standards of care were already high. After instituting the checklist procedures, complication rates dropped from 27% to 16% (risk reduction, 11%; 95% confidence interval, 8.7-12.4). In-hospital mortality dropped from 1.5% to 0.8%. No improvement was found in a similar group of hospitals where the safety list had not been implemented.
This study was unique in several ways: The checklist, rather than just being confined to variables important to the operating room, consisted of essential items at all stages of hospitalization. Another feature of this report is that, unlike the World Health Organization report on the value of checklists, the study hospitals already had a high level of care. The authors pointed out that implementing the checklist took at least 6 months and required detailed attention from more than just the surgical staff. The study clearly pointed out the value of a comprehensive checklist for reducing surgical morbidity and mortality, even in well-functioning hospitals.
Abstract
Effect of a Comprehensive Surgical Safety System on Patient Outcomes
deVries EN, Prins HA, Crolla RM, et al; SURPASS Collaborative Group
N Engl J Med. 2010;363:1928-1937
Summary
How effective is a comprehensive surgical safety checklist in reducing adverse postoperative events? The authors conducted a randomized before-and-after trial in 6 Dutch hospitals where the standards of care were already high. After instituting the checklist procedures, complication rates dropped from 27% to 16% (risk reduction, 11%; 95% confidence interval, 8.7-12.4). In-hospital mortality dropped from 1.5% to 0.8%. No improvement was found in a similar group of hospitals where the safety list had not been implemented.
Viewpoint
This study was unique in several ways: The checklist, rather than just being confined to variables important to the operating room, consisted of essential items at all stages of hospitalization. Another feature of this report is that, unlike the World Health Organization report on the value of checklists, the study hospitals already had a high level of care. The authors pointed out that implementing the checklist took at least 6 months and required detailed attention from more than just the surgical staff. The study clearly pointed out the value of a comprehensive checklist for reducing surgical morbidity and mortality, even in well-functioning hospitals.
Abstract
