Key result
WHO Surgical Safety Checklist implementation linked to ~27% lower in-hospital mortality in adult surgical patients.
Why the study?
Does the implementation of the WHO Surgical Safety Checklist reduce in-hospital mortality in adult surgical patients?
Cohort (n=70,639)
No
Does the implementation of the WHO Surgical Safety Checklist reduce in-hospital mortality in adult surgical patients?
Implementation of the WHO Surgical Safety Checklist significantly reduced in-hospital mortality and length of stay in adult surgical patients in a Latin American tertiary center.
Checklist implementation was associated with lower mortality; extends prior evidence to Latin America but leaves open need for prospective confirmation.
Health care organizations are unsafe. Numerous centers have incorporated the WHO Surgical Safety Checklist in their processes with good results; however, only limited information is available about its effectiveness in Latin America. We aimed to evaluate the impact of the checklist implementation on the in-hospital morbidity and mortality rate in a tertiary health care center. After Institutional review board approval, and using data from our hospital administrative records, we conducted a retrospective analysis of all surgical encounters (n = 70,639) over the period from January 2005 to December 2012. Propensity scoring (PS) methods (matching and inverse weighting) were used to compare the pre and postintervention period, after controlling for selection bias. After PS matching (n = 29,250 matched pairs), the in-hospital mortality rate was 0.82% [95% confidence interval (CI), 0.73-0.92] before and 0.65% (95% CI, 0.57-0.74) after checklist implementation [odds ratio (OR) 0.73; 95% CI, 0.61-0.89]. The median length of stay was 3 days [interquartile range (IQR), 1-5] and 2 days (IQR, 1-4) for the pre and postchecklist period, respectively (P < 0.01).This is the first Latin American study reporting a decrease in mortality after the implementation of the WHO Surgical Checklist in adult surgical patients. This is a strong and simple tool to make health care safer, especially in developing countries.
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Lacassie et al. (2016) conducted a cohort in Surgical encounters (n=70,639). WHO Surgical Safety Checklist vs. Pre-intervention period was evaluated on In-hospital mortality rate (OR 0.73, 95% CI 0.61-0.89). Implementation of the WHO Surgical Safety Checklist reduced in-hospital mortality from 0.82% to 0.65% (OR 0.73; 95% CI 0.61-0.89) in adult surgical patients.
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