Elzerie de Jager1,2, Ronny Gunnarsson3,4, Yik-Hong Ho5. 1. College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia. elzerie.dejager@my.jcu.edu.au. 2. Townsville Clinical School, The Townsville Hospital, Townsville, QLD, 4814, Australia. elzerie.dejager@my.jcu.edu.au. 3. Research and Development Unit, Primary Health Care and Dental Care, Narhalsan, Southern Älvsborg county, Region Västra Götaland, Sweden. 4. Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 5. Discipline of Surgery, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
Abstract
BACKGROUND: The World Health Organization Surgical Safety Checklist (WHO SSC) has been widely implemented in an effort to decrease surgical adverse events. The effects of the checklist on postoperative outcomes have not previously been examined in Australia, and there is limited evidence on the effects of the checklist in the long term. METHODS: A retrospective review was conducted using administrative databases to examine the effects of the implementation of the checklist on postoperative outcomes. Data from 21,306 surgical procedures, performed over a 5-year time period at a tertiary care centre in Australia where the WHO SSC was introduced in the middle of this period, were analysed using multivariate logistic regression. RESULTS: Postoperative mortality rates decreased from 1.2 to 0.92% [p = 0.038, OR 0.74 (0.56-0.98)], and length of admission decreased from 5.2 to 4.7 days (p = 0.014). The reduction in mortality rates reached significance at the 2-3 years post-implementation period [p = 0.017, OR 0.61 (0.41-0.92)]. The observed decrease in mortality rates was independent of the surgical procedure duration. CONCLUSION: Implementation of the WHO SSC was associated with a statistically significant reduction in mortality and length of admission over a 5-year time period. This is the first study demonstrating a reduction in postoperative mortality after the implementation of the checklist in an Australian setting. In this study, a relatively longer period examined, comparative to previous international studies, may have allowed factors like surgical culture change to take effect.
BACKGROUND: The World Health Organization Surgical Safety Checklist (WHO SSC) has been widely implemented in an effort to decrease surgical adverse events. The effects of the checklist on postoperative outcomes have not previously been examined in Australia, and there is limited evidence on the effects of the checklist in the long term. METHODS: A retrospective review was conducted using administrative databases to examine the effects of the implementation of the checklist on postoperative outcomes. Data from 21,306 surgical procedures, performed over a 5-year time period at a tertiary care centre in Australia where the WHO SSC was introduced in the middle of this period, were analysed using multivariate logistic regression. RESULTS: Postoperative mortality rates decreased from 1.2 to 0.92% [p = 0.038, OR 0.74 (0.56-0.98)], and length of admission decreased from 5.2 to 4.7 days (p = 0.014). The reduction in mortality rates reached significance at the 2-3 years post-implementation period [p = 0.017, OR 0.61 (0.41-0.92)]. The observed decrease in mortality rates was independent of the surgical procedure duration. CONCLUSION: Implementation of the WHO SSC was associated with a statistically significant reduction in mortality and length of admission over a 5-year time period. This is the first study demonstrating a reduction in postoperative mortality after the implementation of the checklist in an Australian setting. In this study, a relatively longer period examined, comparative to previous international studies, may have allowed factors like surgical culture change to take effect.
Authors: Oscar E C van Maarseveen; Wietske H W Ham; Nils L M van de Ven; Tim F F Saris; Luke P H Leenen Journal: Eur J Trauma Emerg Surg Date: 2019-08-07 Impact factor: 3.693
Authors: Davide Ferorelli; Marcello Benevento; Luigi Vimercati; Lorenzo Spagnolo; Luigi De Maria; Antonio Caputi; Fiorenza Zotti; Gabriele Mandarelli; Alessandro Dell'Erba; Biagio Solarino Journal: Front Public Health Date: 2022-02-08
Authors: Andrea Niederhauser; Stephanie Züllig; Jonas Marschall; Alexander Schweiger; Gregor John; Stefan P Kuster; David Lb Schwappach Journal: BMJ Open Date: 2019-10-28 Impact factor: 2.692