Checklist Evidence - Related Articles
Since the release of the WHO Surgical Safety Checklist in June 2008 numerous articles have been published demonstrating the benefits of using the checklist in operating rooms and ways in which other hospitals have implemented the checklist. Some of the articles that are considered to be the most influential are included on this page below.
The WHO Surgical Safety Checklist reduced the rate of deaths and complications by more than one third in our eight pilot hospitals. The rate of major inpatient complications dropped from 11% to 7%, and the inpatient death rate following major operations fell from 1.5% to 0.8% after implementation of the checklist. The effect was of similar magnitude in both high and low/middle income country sites. The full text of the paper is available free of charge as an Online First publication here.
Deutsches Ärzteblatt International is the German Medical Association's official international bilingual science journal. This article analyzes 20 articles that were written about the WHO Surgical Safety Checklist. Based on their analysis the authors concluded that the checklist should be understood not merely as a list of items to be checked off, but as an instrument for the improvement of communication, teamwork, and safety culture in the operating room, and it should be implemented accordingly. To review this articles, please click here.
This article out of the Netherlands was a retrospective cohort study of adult patients undergoing non-day case surgery in a tertiary university hospital. After checklist implementation, crude mortality decreased from 3.13% to 2.85% (P = 0.19). Implementation of the WHO Surgical Checklist reduced in-hospital 30-day mortality. This effect was strongly related to checklist compliance. To review the abstract, please click here.
Use of a comprehensive surgical safety checklist and implementation of a structured team training curriculum produced a statistically significant decrease in 30-day morbidity. Adoption of a comprehensive checklist is feasible with team training intervention and can produce measurable improvements in patient outcomes. To review the abstract, please click here.
Safer surgery: how a checklist can make orthopaedic surgery safer is an article that focuses on the importance of surgical safety checklists in orthopaedic surgery. It focuses on the importance of better teamwork and communication in operating theatres. Teamwork is definable and measurable and can be improved through formal structured communication, such as checklists. To review the abstract, please click here.
The Veteran's Health Administration (VHA) implemented a formalized team training program in 74 of their facilities that included the use of a surgical safety checklist. The hospitals that participated in this program experienced an 18% reduction in mortality. To learn more about the results that were published in the Journal of the American Medical Association, click here.
The SURPASS checklist was developed in the Netherlands. Implementation of this comprehensive checklist was associated with a reduction in surgical complications and mortality in hospitals. The full text of the paper is available free of charge as an Online First publication here.
A study at Children's Hospital in Boston observed the implementation of a surgical safety checklist modified for a pediatric population. Results of the pilot test showed improvements in teamwork, communication, and adherence to process measures. An abstract from this study is available here.
A study at the Virginia Mason Medical Center in Seattle, Washington observed the effectiveness of the checklist in improving team building. The results and discussion offer insight into changing the hierarchical culture of the operating room. An abstract from this study is available here.