Sunday, January 18, 2009

Surgery Checklists Save Lives

The old adage that words can't hurt anyone tend to be true in many cases, but that is not the case with surgical theaters. The right words in the operating room can end up saving lives on the table, according to a study published by the New England Journal of Medicine. It was found that the use of a simple checklist to make sure all the equipment is in order and everything is done correctly can save lives, as well as potentially cut complications because of a procedure by almost a third or more.

The study noted that death rates dropped from 1.5% prior to the inclusion of the checklist to 0.8% after it was instituted. Complications that arose form surgical procedures were also noted to have dropped, becoming 7% from the 11% it was prior. The numbers may seem small, but the study's authors said they had never expected any sort of dramatic reductions or changes. In fact, the results were revealed to be much larger than the initial estimates made by the team.

The checklist suggested included various items that were carried out over the course of an operation – seven of them prior to administering anesthesia, seven just before the first incision is made, and the remainder before the patient is allowed to leave the operating theater. The study included numerous basic safety issues, which have all been linked to one medical screw-up or another in the past. These include reminding doctors to double check the identity of the patient, the type of surgery that is required, whether or not there is an adequate supply of blood for excess bleeding, and whether all the equipment were accounted for after the operation.

The checklists had manage to improve compliance only by some teams, with some of them still not adhering to the list. Checklists could be credited with the improvement, but there's not enough data to confirm such an assumption. The change in behavior is considered trivial by many experts, and the reduction did not seem to be enough of a change to make the findings concrete.

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