The study, published in the 'New England Journal of Medicine', found that adhering to the checklist system brought down the in-hospital deaths to half the number in low-income countries and reduced post-surgery complications drastically.
In view of "Safe Surgery Saves Lives" initiative of the World Health Organization, its experts developed a checklist to control surgical disasters. The single-leaf checklist takes care of operative procedures in three stages of surgery: before administering anesthesia
define, before incising, before removing patient from operation room.
Study leader, Dr. Atul Gawande who led the team designing the WHO Surgical Safety Checklist, said, "The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery. Not everyone on the operating teams was happy to try it. But the results were unprecedented. And the teams became strong supporters."
An associate professor at Harvard School of Public Health and a surgeon at Boston's Brigham and Women's Hospital, Dr Gawande explained: "They indicate that gaps in teamwork and safety practices in surgery are substantial in countries both rich and poor. With the annual global volume of surgery now exceeding even the volume of childbirth, the use of the WHO checklist could reduce deaths and disabilities by millions. There should be no time wasted in introducing these checklists to help surgical teams do their best work to save lives."
The researchers investigated surgical complication rates in eight countries before and after using checklist system. Four low-income countries namely Tanzania, Jordan, India and Philippines and four high-income countries of New Zealand, United States, Canada and Britain, were considered.
Identity of patient, his or her medical history including any allergies, marking surgery spot before anesthesia, review of antibioticdefine-use, important surgical steps before incision and counting surgical instruments and sponges after procedure are some of the points included in the WHO checklist.
When checklists were implemented, complication rates dropped from 11 to 7 percent. In low-income countries, and death rates fell from 2 to 1 percent. However, no significant change in death rate was observed for high-income countries.
Checklists were found to have similar effects in hospitals of both the groups in Auckland, Toronto, London, Seattle, New Delhi, Amman, Manila and Ifakara. Gawande believes that reducing surgical complications is very important. He noted, "If we could put this in all hospitals, we could save US$20 billion a year in costs, plus the harm."
In all, it just takes few minutes for the checklist coordinator to check and confirm if the team has completed all tasks before proceeding further.
According to the WHO, most of the surgical complications are preventable. Every year worldwide, 234 million important surgeries are performed and in the developing countries, around 5-10 percent patients die following post-surgical complications such as blood clots, heart attack and stroke.
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