Implementation of the WHO Surgical Safety Checklist at a teaching hospital in India and evaluation of the effects on perioperative complications.

Abstract

The WHO Surgical Safety Checklist was developed to help operating teams reduce the occurrence of patient harm. The Checklist is a simple, practical tool that any surgical team in the world can use to ensure that the preoperative, intraoperative, and postoperative steps that have been shown to benefit patients are undertaken in a timely and efficient way. This study was carried out at Rajarajeswari Medical College Hospital, Bangalore, India, to study the effects of the WHO Surgical Safety Checklist on mortality and morbidity in surgical patients, to identify the potential problems in the long-term implementation of the same, and to document the complications in patients undergoing a major surgery during the study period. Data collection followed patients prospectively until discharge or for 30days, whichever came first, for complications and death. There were a total of 73 complications during the period of the study (4.1%). Of these, more than half (44) were surgical wound infections. The proportion of patients who received prophylactic antibiotics was 100% during the period of the study and the checklist identified a deficit and corrected the same in 27 patients. The checklist was successfully implemented in the said hospital, and the appropriate processes were studied. The use of the checklist was successful in drawing the attention of the personnel to the issue of patient safety, its magnitude, and the appropriate steps to be taken in this regard. The number of omissions in the operation rooms was significantly reduced.