Hospital checklists chop surgical death rates in half

As we've noted in prior posts, hospital checklists have helped hospital caregivers both reduce infection rates and save money. Now, new research published in this week's New England Journal of Medicine shows that such measures can cut the risk of death for surgical patients practically in half. 

Six hospitals in the Netherlands were instructed to use a checklist system that consisted of 100 pre- and post-operative instructions, including ensuring blood availability, double-checking surgical sites and ensuring proper medication administration. The other five hospitals acted as control sites. 

At the six checklist hospitals, roughly 7,600 surgical patients were observed--half before the implementation of the checklist, and half after. Hospitals that used checklists saw mortality rates for patients drop from 1.5 percent to 0.8 percent. No outcomes varied at the control hospitals. 

Dr. John Birkmeyer, director of the Center for Healthcare Outcomes and Policy at the University of Michigan, wrote in an editorial about the study that such statistics move checklists out of the "good idea" category and squarely into the "standard of care" column. 

"This study confirms previous research that showed the use of checklists can have a dramatic effect in both reducing the risk of dying after surgery and suffering other types of complications," Birkmeyer said.

He added that because checklists also were found to have reduced post-surgical complications by one-third, their value primarily could be traced to teamwork efforts. "This implies checklists work less because of specific content, but more because of the indirect effects on teamwork," Birkmeyer wrote. 

To learn more:
- here's the study's abstract in the New England Journal of Medicine
- read Birkmeyer's commentary, also in NEJM (reg. required)
- check out this HealthDay News article
- read this Reuters piece

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.