Surgical checklists save lives

In 2007, the World Health Organisation (WHO) launched a campaign under the slogan Safe Surgery Saves Lives. An outcome of the campaign was the development of a customised checklist, for use in operations.

The checklist is comprised of 20 items, which include making sure the right patient is being operated on, the right procedure is being performed in the right place, anaesthesia is properly induced and maintained, and infections are avoided. The checklist is used before anaesthesia is administered, before the actual operation begins, and after the operation has ended.

“The checklist contributes to a surgical team’s feeling of preparedness, both in advance of normal operations and when unexpected events occur,” says quality coordinator Jan Gustav Hollund at Stavanger University Hospital (SUS).

In his master’s thesis, Hollund together with PhD student Arvid Steinar Haugen at the University of Bergen, and PhD student Sindre Høyland and professor Karina Aase at UiS, explored how the checklist is used by surgical teams at Haukeland University Hospital in Bergen.

“The checklist procedure induces a pep-talk, by strengthening the team spirit and team confidence,” says Hollund.

“The checklist has demonstrated reductions in both fatalities and complications at hospitals in UK and the Netherlands, and we are now studying whether similar gains can be achieved in Norway,” says PhD student Haugen.

Haugen refers to reductions in mortality close to 40 per cent, and as much as 60 percent for complications.

“One of the clearest benefits of using the checklist lies in standardising team communication during an operation, so that each team member shares important information with the others.” “However, the checklist has its limitations. It must be short and simple to use, and safe work practices are much more than a checklist,” Haugen points out.

“Up to 2010, the checklist had been adopted at almost 4 000 hospitals in 122 countries worldwide. The checklist has also been well received at many Norwegian hospitals. In addition, the checklist has become part of the national In Safe Hands patient safety campaign , launched in Norway earlier this year.

Text: Silje Stangeland
English translation: Rolf E Gooderham

Read also: Creating safer surgery

Read more about Risk Management and Societal Safety Research at the University of Stavanger