Surgical safety checklists linked to reduced death risk


The implementation of surgical safety checklists (SSCs) at a tertiary care hospital is associated with a reduced risk of death within 90 days after surgery, according to a study published by JAMA Surgery. Hospital length of stay was reduced after implementation of SSCs.

Inpatients worldwide may expect a 30-day mortality of 1.5 percent after noncardiac surgery, depending on the region where surgery is performed, the surgical procedure, and the patients' other health conditions. Implementation of surgical safety checklists (SSCs) has been found to reduce the incidence of perioperative complications and 30-day mortality.

Checklists aim to reduce risk and prevent patient harm by recognizing high-risk situations and optimizing communication, by minimizing the incidence of errors, and by improving latent conditions. The association of the introduction of SSCs with 90-day mortality has been unclear.

Dr Matthias Bock of Bolzano Central Hospital, Bolzano, Italy and colleagues examined the outcomes of surgical procedures performed during the 6 months before and after the introduction of SSCs at a public, university-affiliated hospital in Italy. The researchers collected data on 90-day all-cause mortality, 30-day all-cause mortality, length of hospital stay, and 30-day readmission rate among patients undergoing noncardiac surgery. The SSCs for this study included 17 to 24 items.

"To our knowledge, this report is the first on the association of SSCs and 90-day all-cause mortality, which might be even more important than 30-day all-cause mortality. Thirty-day all-cause mortality might fail to capture intermediate-term complications, such as anastomosis leakage or pulmonary embolism, which occur despite prophylaxis late after trauma or genitourinary and general surgery," the authors write.

"The observed decline in length of stay suggests potential cost savings after the implementation of SSCs. Further trials should address this hypothesis and the effect on quality of care owing to a reduction of the costs of complications or unplanned reoperations."

SSCs, JAMA Surgery, Dr Matthias Bock, Bolzano Central Hospital, Europe, US