Effects of Implementation of W.H.O Surgical Safety Check List: Our Institutional Analysis

Abstract

To err is human. Human errors and flaws in the system and quality of health care persist despite patient safety initiatives and identification of new strategies of improvement. A significant focus in surgery is to identify strategies and improve patient safety, prevent postoperative complications and any adverse events. The World Health Organization (WHO) surgical safety checklist has been shown to decrease mortality and complications and has been adopted worldwide. A retrospective pre-intervention study was done from September 2014 to August 2015, data analysed, necessary training, changes and awareness was implemented over 1 month and then, a prospective study was done post-intervention using WHO safety check list from October 2015 to September 2016 both at Rajarajeswari Medical College and Hospital, Bangalore, India by implementing the safety check list and by corrections of errors present during the pre-intervention phase. A total of 216 patients were recorded during the pre-intervention phase, and a total of 248 patients were included in the post-intervention analysis after implementing the WHO safety check list. Our study showed a reduction of intraoperative surgical complications from 5.1 to 2.41% and from 6.48 to 4.44% in postoperative surgical complications after the implementation of safety check list. There were significant reductions in anaesthesia complications, during and after surgery post implementation (intraoperative from 2.78 to 1.61%, postoperative from 1.4 to 0.8%). We also observed a significant change in the death rates post-implementation. Intraoperative death reduced from 1.4 to 0.4% and postoperative deaths reduced from 12.04 to 8%. Surgical safety check list improves the quality of patient care and improves perceptions on patient safety. It significantly reduces the morbidity and mortality by reducing the complications and improving the quality of treatment and health care. It is easy to understand and implement the surgical safety check list after training, proper guidance, and education. It is a must to implement the surgical safety check list in all institutions to improve the patient safety and to reduce the errors in patient care.