The Effect of a Modified World Health Organization Surgical Safety Checklist on Postoperative Complications in a Tertiary Hospital in Iran,2012

Abstract

Objective: The aim of this study is to modify the World Health Organization (WHO) Surgical Safety Checklist in order to be compatible to a hospital in Iran and measure effect of implementing this checklist on postoperative complications. Methods: In a cross-sectional study the views of surgeons and anesthesiologists of the main teaching hospital in Tabriz -Imam Reza Hospital-were taken by a form attached to the main checklist. The participants in this study asked to write their opinions on each item of checklist based on the environment of the hospital. Then, we performed before-after study to determine effect of a modified checklist implementing on postoperative complications. Results: Surgeons and anesthesiologists had consensus on 15 of 19 items of checklist to remain the same and just 4 items recommended to be changed. In pre intervention period of study, 100 patients (51 males and 49 females) were enrolled with the mean age of 48.5±13.5years. The number of patients in the post intervention period was the same, but 49 males and 51 females, the mean age was 47.5 ±14.6 years. The incidence of any complications in pre intervention period was 30%, but this rate in post intervention period was 12% and the difference between 2 periods of study was statistically significant (p=0.002). Conclusion: World Health Organization Surgical Safety Checklist is betterto modify based on the local needs and facilities in each hospital. After implementing of a modified surgical safety checklist, complications decreased by 58%.

Postoperative Adverse Events Inconsistently Improved by the World Health Organization Surgical Safety Checklist: A Systematic Literature Review of 25 Studies

“…Multinational studies that did not differentiate between high‐ and low‐income countries were not included in the sub‐analysis. In developed countries, 36 % of studies (5 [23, 33, 35–37] out of 14 studies [6, 22–25, 33, 35–42]) showed a significant decrease in total complication rates compared to 83 % of studies (5 [38, 43–46] out of 6 studies [26, 38, 43–46]) conducted in developing nations. Mortality was not decreased in any of the 13 studies in developed nations [6, 22–25, 35, 37, 38, 41, 42, 47–49], whereas it was decreased in 75 % of studies (3 [26, 38, 45] out of 4 studies [26, 38, 45, 46]) in developing nations.…”

“…The total complication rate was reported in 20 studies [6, 22-26, 33, 35-41, 43-46, 49, 50], ten reported significantly decreased rates (range 34-67 %) [23,33,35,37,38,[43][44][45][46]50] and one reported increased complication rates (25 %) [39]. Mortality rates were reported in 18 studies [6, 22-26, 35, 37, 38, 41, 42, 45-51]; four reported a significant decrease in rates (range 43-100 %) [26,38,45,50], whilst one reported an increase following the implementation of the checklist (238 %) [35].…”

Surgical Teams’ Attitudes and Views Concerning the Surgical Safety ChecklistTR

“…Despite the reported benefits, compliance with SSC is low (3,25,26). Although there are studies investigating compliance with the use of SSC in international literature (1,3,5,8,10,13,14,23,24,27), only limited research has been undertaken in Turkey (26,(28)(29)(30)(31). The current study aimed to determine the surgical team's views and attitudes concerning the use of SSC TR .…”

“…Original Article in the rate of mortality (from 1.5 to 0.8%) and complications (from 11 to 7%) (13). This provided that the list being widely used in many hospitals around the world (1,14,15).…”

“…In previous studies about SSC usage, it has been shown to reduce surgical errors, postoperative complications (8,13,(18)(19)(20)(21) and mortality (19,20,22), improve the communication between surgical team members (3,8,22,23) and offers promising results in increasing patient safety (4,10,18,22). However, SSC usage is not sufficient alone to improve patient outcomes.…”