Surgical safety checklists may not improve patient outcomes after all

Surgical safety checklists didn't improve operative mortality, readmission rates and emergency department visits within 30 days after discharge at Canadian hospitals, according to a study published in the New England Journal of Medicine.

David R. Urbach, M.D., of the University of Toronto and colleagues surveyed all the acute care hospitals in the province to determine the checklists' effectiveness, according to the study.

Researchers compared operative mortality, surgical complication rates, lengths of stay, readmission rates and emergency department visits within 30 days after discharge before and after Ontario hospitals implemented the checklist.

The 101 hospitals studied performed 109,341 surgeries in the three months before implementing the checklist and 106,370 in the three months following the order. The adjusted risk of death during a hospital stay or within 30 days of surgery before implementation was 0.71 percent, compared to 0.65 percent afterward. Adjusted risk of surgical complications remained almost the same at 3.86 percent before the checklist and 3.82 percent after, according to the study.

There was no association between the surgical safety checklist implementation and a significant reduction of death or complications, researchers concluded.

Monthly surgeon-led mortality reviews may be one way for hospitals to improve their observed-to-expected ratios; these reviews improved observed-to-expected ratios and University HealthSystem Consortium postsurgical relative rankings, FierceHealthcare previously reported. The reviews covered mortality rates, patient safety indicators and hospital acquired conditions. Each month, one surgeon from each service led a review of all incidents with reporting of preventability and coding accuracy.

To learn more:
- here's the study

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