A recent study in Ontario, Canada, found surgical safety checklists may not be as effective in improving quality outcomes as previously believed, according to research published in New England Journal of Medicine.
Researchers compared clinical quality data from 101 acute-care hospitals that implemented any surgical safety checklist between June 2008 and September 2010.
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They found the 30-day surgical mortality rate was 0.71 percent three months before checklist implementation and 0.65 percent three months after implementation, not a statistically significance difference. The risk of surgical complications was 3.86 percent before implementation and 3.82 percent after.
In 2010, Canada's Ministry of Health and Long-Term Care mandated that hospitals adhere to surgical safety checklists, but they did not require formal training of proper checklist adherence, according to a Medscape report discussing the study.
Lucian Leape, MD, professor at the Harvard School of Public Health, wrote an accompanying editorial to the study, also published in NEJM, and said, "it is not the act of ticking off a checklist that reduces complications, but performance of the actions it calls for," according to the Medscape report, suggesting proper implementation and use requires more in-depth interaction with the checklist instead of simply running through tasks.
Dr. Leape said fully implementing a checklist requires certain resources and expertise, investment in adherence by all clinical staff and adaptation to individual needs.
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