Why the study?
Preventable intraoperative errors and adverse events remain a concern in arthroplasty procedures despite the widespread adoption of the WHO surgical safety checklist.
Does a novel arthroplasty-specific surgical checklist reduce preventable adverse events in patients undergoing primary or revision hip and knee arthroplasty compared to the standard WHO checklist?
Does a novel arthroplasty-specific surgical checklist reduce preventable adverse events in patients undergoing primary or revision hip and knee arthroplasty compared to the standard WHO checklist?
A subspecialty-specific arthroplasty checklist significantly reduces preventable surgical errors and enhances patient safety compared to the standard WHO checklist.
Answers are grounded in this paper and cite their sources.
Arthroplasty-specific checklist may reduce errors; leaves open superiority to WHO SSC pending randomized trials.
Introduction: Despite the widespread adoption of the World Health Organization (WHO) surgical safety checklist (SSC), preventable intraoperative errors and adverse events remain a concern in arthroplasty procedures.This study introduces and evaluates the effectiveness of a novel, threephase, arthroplasty-specific surgical checklist aimed at improving patient safety.Materials and methods: A novel 37-point checklist covering preoperative, intraoperative, and postoperative phases was developed and implemented across two tertiary centers.A prospective cohort of 520 patients undergoing primary or revision hip and knee arthroplasty (2022-2023) using the new checklist was compared to a retrospective control group of 418 patients (2019-2021) managed with the standard WHO checklist.Adverse events and near-miss errors were analyzed using descriptive statistics and appropriate significance testing.Results: The overall incidence of preventable adverse events decreased significantly from 6.9% in the control group to 1.7% in the study group (p < 0.01).Notable reductions were observed in retained drain plugs (3.1 to 0%, p < 0.001), retained gauze pieces (1.4 to 0.2%, p < 0.001), and mismatched implants (0.9 to 0%, p < 0.001).The checklist demonstrated high reproducibility and interobserver reliability, with near-perfect agreement between surgeons and circulating nurses ( = 0.98). Conclusion:This study demonstrates that a comprehensive, subspecialty-specific arthroplasty checklist significantly reduces preventable surgical errors and enhances patient safety.It offers a practical and reproducible tool adaptable to diverse clinical settings, with potential for broader surgical and institutional implementation.
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Tawri et al. (2025) studied this question.
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