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Implementation of the World Health Organization Surgical Safety Checklist Correlates with Reduced Surgical Mortality and Length of Hospital Admission in a High-Income Country

Artikel i vetenskaplig tidskrift
Författare E. de Jager
Ronny K Gunnarsson
Y. H. Ho
Publicerad i World Journal of Surgery
Volym 43
Nummer/häfte 1
Sidor 117-124
ISSN 0364-2313
Publiceringsår 2019
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Sidor 117-124
Språk en
Länkar dx.doi.org/10.1007/s00268-018-4703-...
Ämnesord postoperative complications, provider volume, adverse events, outcomes, surgery, morbidity, Surgery
Ämneskategorier Kirurgi

Sammanfattning

BackgroundThe World Health Organization Surgical Safety Checklist (WHO SSC) has been widely implemented in an effort to decrease surgical adverse events. The effects of the checklist on postoperative outcomes have not previously been examined in Australia, and there is limited evidence on the effects of the checklist in the long term.MethodsA retrospective review was conducted using administrative databases to examine the effects of the implementation of the checklist on postoperative outcomes. Data from 21,306 surgical procedures, performed over a 5-year time period at a tertiary care centre in Australia where the WHO SSC was introduced in the middle of this period, were analysed using multivariate logistic regression.ResultsPostoperative mortality rates decreased from 1.2 to 0.92% [p=0.038, OR 0.74 (0.56-0.98)], and length of admission decreased from 5.2 to 4.7days (p=0.014). The reduction in mortality rates reached significance at the 2-3years post-implementation period [p=0.017, OR 0.61 (0.41-0.92)]. The observed decrease in mortality rates was independent of the surgical procedure duration.ConclusionImplementation of the WHO SSC was associated with a statistically significant reduction in mortality and length of admission over a 5-year time period. This is the first study demonstrating a reduction in postoperative mortality after the implementation of the checklist in an Australian setting. In this study, a relatively longer period examined, comparative to previous international studies, may have allowed factors like surgical culture change to take effect.

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