Surgical Safety Checklist will save lives Thursday August 27, 2009

A “Surgical Safety Checklist” is to be distributed to every hospital in New Zealand and Australia as part of a World Health Organisation (WHO) initiative to reduce mortality rates and the incidence of complications during surgery. The Checklist was launched at Parliament today (27/8) by the Minister of Health Tony Ryall and is supported by the Royal Australasian College of Surgeons (RACS) and the Australian and New Zealand College of Anaesthetists (ANZCA). Internationally, an estimated 234 million operations are performed annually and surgical complications are inevitable but sometimes preventable. The 21-item checklist is designed to improve team communication and consistency of care before, during, and after surgery. The Chairman of ANZCA’s Quality and Safety Committee, Professor Alan Merry, said the checks, which take just 120 seconds to complete and involve no additional expense to the hospital or patient, take place in three phases. The first occurs before the induction of anaesthesia. “Errors and omissions in the process of perioperative care need to be identified before patients are anaesthetised, not after,” Professor Merry said. The second phase takes place before the first incision and the third before the patient is taken from the operating theatre. These include checks on patient identity, operation side and site, availability of special equipment and relevant images, surgical and anaesthetic procedures and labeling of specimens for testing. The anaesthetists, surgeons and other theatre staff work through the Checklist together, ensuring no preventable errors are about to be made. “The Checklist has real potential to save lives, reduce operating room errors, and improve patient safety. We want to see it displayed in every operating theatre in every hospital in New Zealand and Australia,” says RACS Censor in Chief, Ian Civil. “The College will be doing everything we can to encourage the use of the Checklist,” he says. The Checklist has been adapted for New Zealand and Australia and is based on the highly successful WHO surgical safety checklist, which was originally trialled in eight hospitals around the world – including: Auckland, Toronto, New Delhi, Manila and London. The global study involved almost 8000 patients and found that death rates for surgical patients was 1.5% before the checklist was introduced and fell to 0.8% after its introduction, while inpatient complications fell from 11% of cases before to 7% after. The results of the study were published in The New England Journal of Medicine in January this year.

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS

Principal Investigator at Auckland City Hospital for the WHO study, Professor Alan Merry, says Auckland City Hospital was so impressed with the results it has adopted the checklist for on-going use and hopes that other New Zealand hospitals will follow suit. “Anaesthesia and surgery are much safer today than they were even 20 years ago, but avoidable mishaps still occur and occasionally these are serious,” he says. Professor Merry says the checklist is a very simple clinical tool that will have an enormous impact on how medical teams prevent mishaps and associated complications. “More importantly it will save lives.” The use of this Checklist in New Zealand hospitals is also supported by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Royal Australian and New Zealand College of Ophthalmologists, the New Zealand Nurses Organisation, the Quality Improvement Committee and the New Zealand Private Surgical Hospitals Association. For more information contact Mr Ian Civil, RACS : 021 963 759: Email ian.civil@surgeons.org Professor Alan Merry, ANZCA : 021 492 297; Email a.merry@auckland.ac.nz Heather Ann Moodie, New Zealand Executive Officer, ANZCA 04 499 1213 Allison Webber – Media Advisor for RACS 04 905 8594 or 021 465 678