WHO's Safer Surgery Checklist initiative may prevent fatal hospital infections

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London, June 25 : The World Health Organisation (WHO) has launched a new initiative in London, which requires surgeons and nurses to run through certain checks before each operation, to avoid fatal hospital infections.

The Safer Surgery Checklist initiative is designed to ensure that basic precautions have been taken before, during and after every operation.

It has been described as the biggest innovation in medicine since the stethoscope.

Research has shown checklists dramatically improve patient care at virtually no cost. A similar checklist to reduce hospital infections is estimated to have saved 1,500 lives in the first 18 months in Michigan.

Surgery these days is as routine as childbirth, and most people usually have two to three operations in their lifetime.

Although serious errors are rare, a study of 38 surgeons in 14 NHS hospitals published in the British Medical Journal found that "most" of them had experience of operating on the wrong part of the body.

"The complexity of medicine has increased to the point where no one person can ensure it is delivered reliably and accurately. We have been struggling for a tool that can help people reliably deliver safe care. The checklist is turning out to be as important to successful care as the stethoscope. I think you could make the case that it is the biggest innovation since the stethoscope," the Independent quoted Atul Gawande, the US surgeon and columnist for the New Yorker who is leading the initiative for the World Health Organisation, as saying.

He said that the checks to be carried out by surgeons and nurses were quite similar to those conducted by pilots before take off, ranging from confirming the site for surgery to counting the number of swabs after the operation had been completed.

He revealed that the surgery checklist was being tested at St Mary's Hospital in London, and seven other hospitals around the world-in the US, Canada, New Zealand, India, Philippines, Tanzania and Jordan.

Referring to a WHO report, Dr. Gawande also revealed that the initiative had already resulted in "substantial reductions in complications and deaths".

"At the start of the pilot in the eight hospitals, 64 per cent of patients missed at least one check. Putting in the checklist cut the failure rate by half and has reduced deaths and complications, though it is too early to put a figure on it. The remarkable thing was we couldn't tell the first world countries from the developing world countries. This has shown we can do something we have never seen before - improve the safety of surgery on a population basis," he said.

In the UK, a coalition of 13 medical organisations has pledged to introduce the checklist to every operating theatre in the country.

"All these professional groups have committed to making this a reality in the UK. We are one of the first countries to get behind it," said Martin Fletcher, chief executive of the National Patient Safety Agency, which is leading the coalition

Mary Harney, the minister for health in Ireland, said announced that the checklist will be introduced in all Irish hospitals by the end of 2009.

"She is determined to beat the UK. A bit of neighbourly rivalry is a good thing," Dr. Gawande said.

He also revealed that the WHO aims to have the checklist operating in 2,500 hospitals in the most populous countries across the world by the end of next year.

"We want it to be in every operating room in the world. We know it works and it has virtually no cost. I do five cases a day and the checklist catches at least one thing (that might otherwise have been missed) each day," he said.

ANI

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