Surgeon's Checklist Saves Lives

ByABC News
January 14, 2009, 7:33 PM

Jan. 15 -- WEDNESDAY, Jan. 14 (HealthDay News) -- A simple checklist that ensures everyone in the operating room is on the same page reduces complications and saves lives, researchers report.

The need for improving safety in surgery is vital since there are some 230 million major operations worldwide each year, 60 million of them in the United States. In fact, the average American undergoes nine surgical procedures in their lifetime.

"Using a surgery checklist designed for safety cut the complication and death rate by a more than a third," said lead researcher 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. "The safety of surgery has now become a major public health concern."

To aid in reducing surgical complications and deaths, Gawande's team developed a one-page checklist that can be read aloud like a pilot's checklist before take off and landing. The list is designed to make sure that all those in the operating room communicate important patient information during what is known as "timeouts": before anesthesia is started; before the first incision is made; and before the patient is rolled out of the operating room.

While each surgery is different, there are common safety points for all procedures, Gawande said. "If we miss them, people are harmed," he said.

One item on the list is making sure an antibiotic is given before the first incision; this alone can reduce the risk of complications by half, Gawande noted. Other items include making sure that everyone in the operating room has been introduced and knows each other's name, that the team is briefed on the amount of blood loss expected, and how long the operation will take.

The report is published in the Jan. 14 online edition of the New England Journal of Medicine.

To test the validity of the checklist, Gawande's team collected data on 7,688 patients. They collected data on 3,733 patients before using the checklist and on 3,955 patients after surgeons started using the checklist.