WHO's safe surgery checklist can reduce deaths and surgery complications by a third

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Geneva, Jan.16 (ANI): Trials conducted in eight cities around the world including New Delhi have revealed that using a surgical checklist, developed by World Health Organisation (WHO), during major operations can reduce deaths and post-surgery complications by one third.

According to Dr. Atul Gawande, lead author of the study and team leader for the development of the WHO Surgical Safety Checklist, the concept of checklist is new in surgery.

"The concept of using a brief but comprehensive checklist is surprisingly new to us in surgery. Not everyone on the operating teams was happy to try it [initially]. But the results were unprecedented. And the teams became strong supporters," said Dr. Atul Gawande.

The results are based on the data collected from 7,688 patients; 3,733 before the implementation of the checklist and 3,955 patients after the checklist was introduced.

The study was carried out in hospitals in both high and lower income settings-in New Delhi (India), Ifakara (Tanzania), Manila (Philippines), , Amman (Jordan), Seattle (United States of America), Toronto (Canada), London (United Kingdom) and Auckland (New Zealand). The reductions in complications proved to be of equal magnitude in high and lower income sites in the study.

"These findings have implications beyond surgery, suggesting that checklists could increase the safety and reliability of care in numerous medical fields. The checklists must be short, extremely simple, and carefully tested in the real world. But in specialties ranging from cardiac care to paediatric care, they could become as essential in daily medicine as the stethoscope," Dr. Gawande informed.

The safe surgery checklist, which was launched by the WHO as a recommended guideline for safe practice last year, has since gained global recognition by operating theatre staff including surgeons and anaesthetists.

It requires only a few minutes to complete at three critical points during operative care - before anaesthesia is administered, before skin incision and before the patient leaves the operating room.

It is intended to ensure the safe delivery of anaesthesia, appropriate prophylaxis against infection, effective teamwork by the operating room staff and other essential practices in perioperative care.

Analysis of studies undertaken in participating hospitals in each of the six WHO Regions, showed that the rate of major complications after undergoing surgery in the operating rooms taking part in the study fell from 11 per cent in the baseline period to 7 per cent after introduction of the checklist. It was a reduction of one third.

In-patient deaths following major operations fell by more than 40 percent (from 1.5 per cent to 0.8 per cent) with implementation of the checklist.

According to the Chairman of the WHO World Alliance for Patient Safety and Chief Medical Officer for England, Sir Liam Donaldson, "'The immediate response to the checklist has been remarkable, and the studies undertaken in the pilot hospitals are significant. They will make a major contribution towards our goal of having 2,500 hospitals around the world using the safe surgery checklist by the end of this year." (ANI)

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