Surgeon and pre-surgery checklist advocate E. Patchen Dellinger had two reasons to celebrate. The results of the study he participated in that showed the benefits of using checklists were posted on the New England Journal of Medicines Web site on Jan. 15, and Washington Gov. Christine Gregoire issued a message encouraging every hospital in the state to jump on the checklist bandwagon the same day.
WHO pre-surgical checklist boon to safety: study
Dellinger, a professor and the vice chairman of the University of Washingtons department of surgery and chief of its division of general surgery, said that he pushed for the 390-bed UW Medical Center in Seattle to be part of a World Health Organization study on checklists to kick-start his efforts to get implementation to 100% at his institution. We had been doing 90-plus percent of whats on the list for many years, said Dellinger, who was part of a work group that helped develop the WHO checklist as well as a variation developed by Washington States Surgical Care and Outcomes Assessment Program, or SCOAP. Lets put it this way: Every time you ask someone to do something new, they ask, Whats the point?
Now, if he gets asked that question, Dellinger can refer doubters to the NEJM report, which suggested that the use of the WHOs pre-surgical safety checklist led to an 11% decline in the number of post-surgical complicationsincluding a 1.5% drop in the ultimate complication: death (See related editorial on medical checklists). The other results of the study showed a decline in the volume of patients with surgical-site infections to 3.4% from 6.2% and the volume of unplanned returns to the operating room falling to 1.8% from 2.4%.
As of last November 2008, the use of the SCOAP checklist is now universal among all surgical departments at the UW Medical Center, and Dellinger said laminated poster-sized copies of the checklist hang in each of the institutions 24 operating rooms.
Hospitalist and patient-safety advocate Robert Wachter, said thatalong with the checklists simplicitythe data showing the benefit of using the checklist will help spur wider implementation, especially when compared with other patient-safety and quality interventions that may appear to be the right thing to do but whose benefits are unproven.
What this study demonstrated is that its possible to do large-scale changes in safety and quality practices and study them rigorously, said Wachter, a professor and associate chairman of the department of medicine at the University of California at San Francisco.
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