GENEVA and WASHINGTON DC, June 24 /CNW/ - With major surgery now
occurring at a rate of 234 million procedures per year - one for every 25
people - and studies indicating that a significant percentage result in
preventable complications and deaths, the World Health Organization (WHO)
launched a new safety checklist for surgical teams to use in operating
theatres, 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 the
best way to reduce surgical errors and improve patient safety."
Several studies have shown that in industrial countries major
complications are reported to occur in 3-16% of inpatient surgical procedures,
with permanent disability or death rates of approximately 0.4-0.8%. In
developing countries studies suggest a death rates of 5-10 % during major
surgery. Mortality from general anaesthesia alone is reported to be as high as
one in 150 in parts of sub-Saharan Africa. Infections and other postoperative
complications are also a serious concern around the world. These studies
suggest that approximately half of these complications may be preventable.
"Surgical care has been an essential component of health systems
worldwide for more than a century.' said Dr Atul Gawande, a surgeon and
professor at Harvard. "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. The Safe Surgery Saves Lives initiative
aims to change this by raising the standards that patients anywhere can
The Safe Surgery Saves Lives initiative is a collaborative effort lead by
the Harvard School of Public Health today and involving more than 200 national
and international medical societies and ministries of health in a effort to
meet the goal of reducing avoidable deaths and complications in surgical care.
Now, the WHO Surgical Safety Checklist, developed under the leadership of, Dr
Gawande identifies a set of surgical safety standards that can be applied in
all countries and health settings.
Preliminary results from a thousand patients in eight pilot sites
worldwide indicate that the checklist has nearly doubled the likelihood that
patients will receive proven standards of surgical care. Use of the checklist
in pilot sites has increased adherence to these standards of care from 36% to
68% and in some hospitals to levels approaching 100%. This has thus far
resulted in substantial reductions in complications and deaths in this group.
Final results on the checklist effect are anticipated within the next few
The checklist identifies three phases of an operation, each corresponding
to a specific period in the normal flow of work: before induction of
anaesthesia ('Sign In'), before skin incision ('Time Out') and before the
patient leaves the operating room ('Sign Out'). In each phase a checklist
coordinator must be permitted to confirm that the team has completed its tasks
before it proceeds with the operation. For example, during the "Sign in" phase
was the surgical site marked and the patient's know allergies checked , or
during the "Sign out" phase where instruments, sponges and needles counted.
The WHO Guidelines and Checklist released today are the first edition.
They will be finalized for dissemination by the end of 2008, after completion
of evaluation in 8 pilot sites globally.
Notes to Editor:
(*) More information about the second Global Patient Safety Challenge Safe
Surgery Saves Lives can be seen at http://www.who.int/patientsafety/
(*) The World Alliance for Patient Safety is a World Health Organization
programme launched in 2004. The Alliance is chaired by Sir Liam Donaldson,
Chief Medical Officer of the United Kingdom. Further information on the work
of the Alliance is available at http://www.who.int/patientsafety/en/
(*) The World Alliance for Patient Safety issues its 2006-2007 Progress
Report and 2008-2009 Forward Programme on the 25 June 2008. Further
information on the Alliance reports is available at
All press releases, fact sheets and other WHO media material may be found
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