Surgical Checklists Reduce Risk of Complications, Readmission and Additional Procedures: Study

The findings of a new study highlight the importance of hospitals adopting and enforcing the use of surgical checklists, indicating that a new patient safety system was effective in reducing the rate of complications, readmissions and repeat surgical procedures among patients.

Norwegian researchers determined the Surgical Patient Safety System (SURPASS) was effective when it was added to the World Health Organizations (WHO) existing surgical safety checklist (SSC), according to a report published this week in the medical journal JAMA Surgery.

The study evaluated data from a Norwegian hospital where the SURPASS checklists were implemented in three surgical departments. including neurosurgery, orthopedics, and gynecology.

Researchers studied the outcomes of more than 9,000 clinical surgical procedures involving SURPASS checklists and compared them to more than 9,600 surgeries where the checklists were not employed.

According to the findings, the SURPASS checklist helped reduce complications and emergency pre-operations. Adding the SURPASS checklist also helped reduce readmissions to the hospital following discharge from surgery. There was no difference in death rates after adding the new checklist.

The findings indicate the addition of the checklist reduced the risk of surgical complications by about 30%, reduced the need of reoperations by more than half, and decreased the rate of readmissions by about two-thirds.

Overall, surgical safety checklists are shown to help improve patient outcomes in surgery. The World Health Organization surgical safety checklist is now mandatory in many countries around the world.

The SURPASS checklist is individualized to be performed by specific doctors or nurses during preoperative and postoperative procedures. They are used as a last point of check before transferring a patient to the next step in the surgical procedure.

When clinicians adhered to the SURPASS checklist there was a decrease in in-hospital complications and emergency re-operations. Among control patients, complications increased, but re-operations, readmissions, and mortality remained unchanged.

“Findings from this study demonstrate that adding the preoperative and postoperative SURPASS checklists to the intraoperative WHO SSC may be clinically advantageous,” the researchers concluded. “We found that the joint application of the 2 surgical checklist systems was associated with reduced in-hospital complications, emergency reoperations, and hospital readmissions.”