Thirty-day outcomes support implementation of a surgical safety checklist. J Am Coll Surg 2012 Dec;215(6):766-76
Date
09/07/2012Pubmed ID
22951032DOI
10.1016/j.jamcollsurg.2012.07.015Scopus ID
2-s2.0-84869488517 (requires institutional sign-in at Scopus site) 118 CitationsAbstract
BACKGROUND: Thirty-day postoperative complications from unintended harm adversely affect patients and their families and increase institutional health care costs. A surgical checklist is an inexpensive tool that will facilitate effective communication and teamwork. Surgical team training has demonstrated the opportunity for stakeholders to professionally engage one another through leveling of the authority gradient to prevent patient harm. The American College of Surgeons National Surgical Quality Improvement Program database is an outcomes reporting tool capable of validating the use of surgical checklists.
STUDY DESIGN: Three 60-minute team training sessions were conducted and participants were oriented to the use of a comprehensive surgical checklist. The surgical team used the checklist for high-risk procedures selected from those analyzed for the American College of Surgeons National Surgical Quality Improvement Program. Trained observers assessed the checklist completion and collected data about perioperative communication and safety-compromising events.
RESULTS: Data from the American College of Surgeons National Surgical Quality Improvement Program were compared for 2,079 historical control cases, 246 cases without checklist use, and 73 cases with checklist use. Overall completion of the checklist sections was 97.26%. Comparison of 30-day morbidity demonstrated a statistically significant (p = 0.000) reduction in overall adverse event rates from 23.60% for historical control cases and 15.90% in cases with only team training, to 8.20% in cases with checklist use.
CONCLUSIONS: Use of a comprehensive surgical safety checklist and implementation of a structured team training curriculum produced a statistically significant decrease in 30-day morbidity. Adoption of a comprehensive checklist is feasible with team training intervention and can produce measurable improvements in patient outcomes.
Author List
Bliss LA, Ross-Richardson CB, Sanzari LJ, Shapiro DS, Lukianoff AE, Bernstein BA, Ellner SJMESH terms used to index this publication - Major topics in bold
ChecklistConnecticut
Female
Health Plan Implementation
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Operating Rooms
Patient Care Team
Patient Safety
Postoperative Complications
Prospective Studies
Safety Management
Surgical Procedures, Operative