| Departments — Benchmarks | Spring 2009 |
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No Sponge Left Behind The checklist, used orally to confirm such items as the safe delivery of anesthesia, the patient’s identity, the site and type of operation, appropriate antibiotic use, and the names and roles of surgical team members, reduced post-surgery complications and deaths by one-third in the eight hospitals that participated in the international study. Overall, the rate of complications went from 11 percent to 7 percent while the inpatient death rate fell by more than 40 percent. “The checklist reduced complications by double digits in every hospital we put it in,” says Atul Gawande ‘94, the team’s leader and an HMS associate professor of surgery at Brigham and Women’s Hospital. “With 234 million operations performed worldwide every year, universal use of this checklist could save hundreds of thousands of lives.” Gawande and his surgical team at Brigham and Women’s Hospital have used the checklist for almost a year. Gawande’s research team screened complications and death rates after surgery in urban hospitals in Canada, England, India, Jordan, New Zealand, the Philippines, Tanzania, and the United States. Outcomes for more than 7,600 patients were analyzed 30 days following their surgeries and included a near-even split in the number of patients with surgeries before and after the checklist was introduced.As a result of the study’s findings, Ireland, Jordan, the Philippines, and the United Kingdom plan to implement the checklist in operating rooms nationwide. In the United States, hospital associations in New York, North Carolina, South Carolina, and Washington State have committed to using it. “Our goal,” says Gawande, “is to get surgical teams worldwide to try it and make it a part of their practice.” The study was part of the World Health Organization’s Safe Surgery Saves Lives campaign and appeared in the January 29, 2009, issue of the New England Journal of Medicine.
Nuño Dominguez is an intern with Focus. Photo: Cultura/Corbis |
Harvard-led study, surgical teams that reviewed a safety checklist before and after major operations cut their rates of deaths and complications.
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