UN health agency creates safety checklist for surgery

The United Nations World Health Organization (WHO) today launched a new safety checklist for operating theatres around the world as part of a major drive to make surgery safer around the world.

WHO says that 234 million major surgeries are now performed every year – equivalent to one for every 25 people – and that significant numbers of patients suffer or even die because of preventable complications.

“Preventable surgical injuries and deaths are now a growing concern,” Dr. Margaret Chan, Director General of WHO, said in a statement today. “Using the checklist is the best way to reduce surgical errors and improve patient safety.”

Several studies have shown that in developing countries 5 to 10 per cent of patients die during major surgery. One in 150 people die from general anaesthesia in sub-Saharan Africa. Major complications are also reported in 3 to 16 per cent of patients in industrialized countries, while infections and other complications are also a serious threat. The studies suggest that about half of these complications may be preventable.

The WHO Surgical Safety Checklist was developed under the leadership of Atul Gawande, a surgeon and professor at Harvard University in the United States.

The checklist identifies three phases of an operation – before the use of anaesthesia, before the beginning of the operation, and before the patient leaves the operating theatre.

In each phase a checklist coordinator confirms that the surgical team has completed its tasks before it proceeds: for example in the first phase, the patient’s known allergies have to be checked off, and in the last phase, surgical instruments, sponges and needles have to be counted.

First results from 1000 patients in eight pilot sites worldwide indicate that the checklist has resulted in substantial reductions in complications and deaths.

“Although there have been major improvements over the last few decades, the quality and safety of surgical care has been dismayingly variable in every part of the world,” Dr. Gawande said, adding that the Safe Surgery Saves Lives initiative that was developed at Harvard and led to the new checklist, “aims to change this by raising the standards that patients anywhere can expect.”

The checklist released today is a first edition. It will be finalized for distribution by the end of this year after completion of evaluations on the eight pilot projects.