Effect of surgical safety checklists on postoperative morbidity and mortality rates, Shiraz, Faghihy Hospital, a 1-year study.

OBJECTIVE

The study intent was to (1) encourage the use of surgical safety checklists and (2) measure the effect checklists have in reducing surgical complications.

DESIGN

An interventional study designed to improve postsurgical outcomes was performed.

SETTING

The study site was a 374-bed referral educational hospital in Shiraz, Iran, with 6 operating rooms. The study lasted 6 months.

PARTICIPANTS

Patient selection involved a convenient sampling method with all eligible patients entering.

INTERVENTION

Our checklist covered 3 surgical stages--before anesthesia, immediately before an incision, and before moving the patient to a recovery room. Persons included were operating room team members.

MAIN OUTCOME MEASURES

Rates of postsurgical complication before and after application of the surgical safety checklist underwent comparison.

RESULTS

Incidence of any complication before and after intervention was 22.9% and 10% (P = .03). Five checklist items were in total compliance. The most common complication was surgical site infection. Implementation of the checklist, responsibility in 2 stages, such as time out and sign out, were significant (P < .05). In most cases, these items reflected the performance of surgeons and anesthesia professionals as compared with the World Health Organization Surgical Safety Checklist.

CONCLUSION

Complications decreased by 57% after intervention. Both high patient information detection and elevated levels of cooperation by surgical personnel were observed. Compliance likely helped prevent some adverse effects associated with surgery.