A new study shows that surgeons who used a verbal checklist before, during and after the procedures were able to reduce surgical errors by more than 40%. The checklist seems to be the best instrument to help doctors and nurses avoid medical errors, according to the study published online in the New England Journal of Medicine.

 

The checklist designed by the World Health Organization (WHO) was tested in eight cities in different parts of the world: Seattle, Toronto, London, Auckland, Amman, New Delhi, Manila and Ifakara, Tanzania. The World Health Organization says that about half of surgery complications are preventable. The simple procedure could save the lives of millions who die due to medical errors.

 

The checklist is designed to follow three major elements: things to do before the anesthesia, things to do before the patient is incised and, finally, what to check for before the patient is taken out of the operating room. This instrument is also designed to promote effective teamwork and prevent problems before, during, or after the surgery.

 

Researchers compared surgery outcomes before and after adopting the checklist to see how much it affected the results for patients who underwent surgeries in those hospitals. The study found the rate of major complications fell from 11% to 7%, and the rate of inpatient deaths following surgery fell more than 40% from 1.5% to 0.8%. As an example, using the checklist in the state of Michigan saved more than 1,500 lives a year and a total of $200 million dollars.

 

Another interesting idea to keep in mind is the fact that the checklist used in the current study required more interaction between surgical team members. In this way, it improved communication between them.

The scientists said the idea for the checklist came from aviation, where there are three such instruments: a checklist before the plane takes off, a checklist during the flight and another one before landing.

 

“Using a surgery checklist designed for safety cut the complication and death rate by a more than a third,” concluded Dr. Atul Gawande, an associate professor of health policy and management at the Harvard School of Public Health and a surgeon at Brigham and Woman's Hospital, Boston, and lead-author of the study. The researchers found the death rate dropped by more than 40 percent when the checklist was introduced, from 1.5 percent to 0.8 percent.

“There should be no time wasted in introducing these checklists to help surgical teams do their best work to save lives,” said Dr. Atul Gawande.

 

Four countries, the United Kingdom, Ireland, Jordan and Philippines, already have plans to introduce the checklist in the hospitals. The checklist program has the potential to prevent large numbers of deaths and medical errors and can improve the safety of surgical patients in diverse clinical and economic environments, the researchers concluded.