Adopting Surgical Safety Checklists Has Little Effect on Mortality

No significant reduction in death or surgical complications with adoption of checklists.
No significant reduction in death or surgical complications with adoption of checklists.

Adoption of surgical safety checklists is not associated with significant reductions in mortality or surgical complications, according to a study published in the New England Journal of Medicine.

To examine the effectiveness of mandatory adoption of checklists, David R. Urbach, M.D., from the University of Toronto, and colleagues surveyed all acute care hospitals in Ontario, Canada, to determine when checklists were adopted.

Operative mortality, rate of surgical complications, length of hospital stay, and rates of 30-day readmissions and emergency department visits were compared for patients undergoing surgical procedures before and after checklist adoption.

The researchers found that 101 hospitals performed 109,341 procedures in the three-month period before adoption of a surgical safety checklist and 106,370 procedures in the three-month period after adoption of the checklist. 

Before implementation of a surgical checklist, the adjusted risk of death during a hospital stay or within 30 days of surgery was 0.71 percent, compared with 0.65 percent after adoption of checklists (P = 0.13). There was no significant difference in the adjusted risk of surgical complications before and after checklist adoption (3.86 versus 3.82 percent; P = 0.29).

"Implementation of surgical safety checklists in Ontario, Canada, was not associated with significant reductions in operative mortality or complications," the authors write.

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