GENEVA and WASHINGTON DC, June 25 With major surgery nowoccurring at a rate of 234 million procedures per year - one for every 25people - and studies indicating that a significant percentage result inpreventable complications and deaths, the World Health Organization (WHO)launched a new safety checklist for surgical teams to use in operatingtheatres, as part of a major drive to make surgery safer around the world.
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"Preventable surgical injuries and deaths are now a growing concern,"said Dr Margaret Chan, Director-General of WHO. "Using the Checklist is thebest way to reduce surgical errors and improve patient safety."
Several studies have shown that in industrial countries majorcomplications are reported to occur in 3-16% of inpatient surgicalprocedures, with permanent disability or death rates of approximately0.4-0.8%. In developing countries studies suggest a death rates of 5-10 %during major surgery. Mortality from general anaesthesia alone is reported tobe as high as one in 150 in parts of sub-Saharan Africa. Infections and otherpostoperative complications are also a serious concern around the world.These studies suggest that approximately half of these complications may bepreventable.
"Surgical care has been an essential component of health systemsworldwide for more than a century.' said Dr Atul Gawande, a surgeon andprofessor at Harvard. "Although there have been major improvements over thelast few decades, the quality and safety of surgical care has beendismayingly variable in every part of the world. The Safe Surgery Saves Livesinitiative aims to change this by raising the standards that patientsanywhere can expect."
The Safe Surgery Saves Lives initiative is a collaborative effort lead bythe Harvard School of Public Health today and involving more than 200national and international medical societies and ministries of health in aeffort to meet the goal of reducing avoidable deaths and complications insurgical care. Now, the WHO Surgical Safety Checklist, developed under theleadership of, Dr Gawande identifies a set of surgical safety standards thatcan be applied in all countries and health settings.
Preliminary results from a thousand patients in eight pilot sitesworldwide indicate that the checklist has nearly doubled the likelihood thatpatients will receive proven standards of surgical care. Use of the checklistin pilot sites has increased adherence to these standards of care from 36% to68% and in some hospitals to levels approaching 100%. This has thus farresulted in substantial reductions in complications and deaths in this group.Final results on the checklist effect are anticipated within the next fewmonths.
The checklist identifies three phases of an operation, each correspondingto a specific period in the normal flow of work: before induction ofanaesthesia ('Sign In'), before skin incision ('Time Out') and before thepatient leaves the operating room ('Sign Out'). In each phase a checklistcoordinator must be permitted to confirm that the team has completed itstasks before it proceeds with the operation. For example, during the "Signin" phase was the surgical site marked and the patient's know allergieschecked , or during the "Sign out" phase where instruments, sponges andneedles counted.
The WHO Guidelines and Checklist released today are the first edition.They will be finalized for dissemination by the end of 2008, after completionof evaluation in 8 pilot sites globally.
Notes to Editor:
* More information about the second Global Patient Safety Challenge SafeSurgery Saves Lives can be seen at http://www.who.int/patientsafety/
* The World Alliance for Patient Safety is a World Health Organizationprogramme launched in 2004. The Alliance is chaired by Sir Liam Donaldson,