Reducing Post Surgical Deaths

Written by Andy Smith, MTM publisher

A piece in the Times of London, 17th April entitled‘Checking the basics helps reduce deaths after surgery’, drew my attentionduring that morning’s breakfast reading.

Since 2008 Scotland has seen a 36.6 percent reduction in post-operative deaths. The article co-authored by Professor Jason Leitch, National Clinical Director of Healthcare Quality and Strategy, and Times journalist Helen Puttick, was derived from a peer reviewed publication in the British Journal of Surgery.

This result was obtained after the national adoption of the WHO checklist in 2008, which as the article points out was derived from airline practices, tying neatly back to my recent opinion piece.

The checklist was originally co-authored by Dr. Atul Gawande who congratulated Scotland on ‘a multi-year effort that has produced some of the largest population-wide reductions in surgical deaths ever documented.’ The data is derived from the study of seven million procedures.

The checklist requires: ‘staff to double-check basics suchas which side of the patient they are operating on, whether the necessarymedication has been given and whether a bed in intensive care is availableshould the patient deteriorate. It also ensures that staff in an operatingtheatre introduce themselves and communicate about the patient and procedure’.

As with all newspapers the piece gives the opportunity forcomment from readers. One of the best, fairly representative of all said, ‘Weput a man in the moon 50 years ago and this was introduced in 2008 not 1908.’

Perhaps there is an opportunity here to give some incentive or protection to those hospitals and clinicians who properly operate the WHO checklist, and train their staff to do so, should a wrong site surgery take place or an avoidable death result? Conversely, to really punish those who do not operate the checklist.