South Carolina hospitals check off 'reduce post-surgical deaths' with safety checklist

Checklists can help improve efficieny and quality measures in a number of work envrionments and a new study makes the case for them being applied to safety initiatives in hospitals. 

The research, set to be published in August in the Annals of Surgery, found that having a safety checklist program implemented in hospitals in South Carolina reduced post-surgical deaths by 22 percent.

A five-year study between the South Carolina Hospital Association, Ariadne Labs, and Harvard T.H. Chan School of Public Health tested the effectiveness in reducing post-surgery deaths by using the World Health Organization Surgical Safety Checklist. The checklist is comprised of 19 prompts for surgical clinicians to review the plan, risk and concerns of the upcoming procedure in order to improve communication and safety within the surgical team.

"Safety checklists can significantly reduce death in surgery. But they won't if surgical teams treat them as just ticking a box," said Ariadne Labs' Executive Director Dr. Atul Gawande in a statement. "With this work, South Carolina has demonstrated that surgery checklists can save lives at large scale -- and how hospitals can support their teams to do it."

The Safe Surgery South Carolina program included 14 hospitals that completed the 12-step implementation process with Ariadne Labs. Armed with personalized checklists, checklist hospitals were compared to non-checklist hospitals to measure 30-day post-surgery deaths. Surgical procedures ranged from a variety of specialties including neurological, thoracic and cardiac, to soft tissue and orthopedic.

Results found that hospitals using a checklist reduced the post-surgery death rate from 3.38 percent in 2010 to 2.84 percent in 2013 while non-checklist hospitals saw a death rate of 3.5 percent in 2010 and 3.71 percent in 2013. These measures totaled a 22 percent difference in mortality between checklist and non-checklist hospitals.

"That is a major reduction in post-surgical mortality and it demonstrates that when done right, the Surgical Safety Checklist can significantly improve patient safety at large scale," said lead author Dr. Alex B. Haynes, associate director of the Ariadne Labs Safe Surgery Program and a surgeon at Massachusetts General Hospital.