Simple surgical checklist reduces deaths, says study led by Indian American

January 15th, 2009 - 1:09 pm ICT by IANS  

Toronto, Jan 15 (IANS) A simple surgical checklist significantly cut down post-operative complications and deaths in eight teaching hospitals across the world, according to a pilot study led by Indian American Atul Gawande. “We know that many surgical complications are preventable,” said Bryce Taylor, Harvard University Health Network’s (UHN) surgeon-in-chief, who co-authored the study with Gawande.

“With approximately 234 million surgeries performed each year worldwide, we owe it to our patients to look at every opportunity to prevent complications during and after surgery,” said Taylor.

Studies in industrialised countries have found that major complications occur in three to 16 percent of inpatient surgeries. Inconsistent approaches also lead to adverse events. For example, there is strong evidence to support using antibiotics within one hour, before incision to reduce the possibility of wound infections.

Launched in October 2007, Toronto General Hospital (TGH) and seven hospitals in New Delhi, Amman, Auckland, Manila, Ifakara (Tanzania), London and Seattle were selected by the WHO and Harvard to pilot a surgical patient safety checklist as part of the WHO’s “Safe Surgery Saves Lives” initiative.

Developed by an international group made up of leading surgeons, nurses, anaesthesiologists and patient safety experts, the WHO checklist was influenced by checklists used in the airline industry to reduce the incidence of airline errors.

Each pilot site implemented the checklist in their operating rooms and tracked changes in the rate of inpatient complication or death within 30 days of surgery.

To establish a baseline, data was collected from a total of 3,733 patients before the implementation of the checklist and 3,955 patients after it was introduced, said a Harvard release.

The TGH surgical team adapted the WHO’s checklist to reflect current surgical practices. The checklist was used at TGH’s 11 operating rooms during a variety of outpatient and inpatient surgeries.

These findings are slated for publication in the Jan 29 edition of the New England Journal of Medicine.

Atul Gawande, born in 1965 in New York, is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, Massachusetts and associate director of its Center for Surgery and Public Health.

He is also an associate professor at the Harvard School of Public Health and an associate professor of surgery at Harvard Medical School.

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