Healthcare News & Insights

Surgical checklists reduce death rates in South Carolina

Surgical checklists can be helpful. They allow the surgery team to streamline processes and make sure critical steps weren’t missed during the procedure. New research offers proof that these checklists are not only beneficial for surgeons – they also save lives. 

Hospitals throughout the state of South Carolina worked with the Harvard T.H. Chan School of Public Health and Ariadne Labs to implement surgical checklists in various facilities, according to a news release. The results of the study were published in the Annals of Surgery.

Improved outcomes

As part of the study, hospitals were asked to start using the World Health Organization’s (WHO’s) Surgical Safety Checklist. While all hospitals in the state were encouraged to participate, the program was completely voluntary.

In all, 14 hospitals got on board with using the checklist as part of the Safe Surgery South Carolina program. These facilities performed nearly 40% of the state’s total inpatient surgeries.

As part of the program, the hospitals worked to refine the WHO’s checklist for the procedures they performed most often, conducting tests and observing how the checklist affected operations.

After five years, researchers compared the performance of South Carolina hospitals that used the surgical checklist to other hospitals across the state, looking specifically at mortality rates 30 days after several types of surgery, including neurological and cardiac procedures.

The result: Participating facilities saw a nearly 22% decrease in the number of patients who died after surgery.

Before implementing checklists, the post-surgery death rate at these hospitals was 3.38%, and it fell to 2.84% afterward. Meanwhile, the state’s other hospitals had mortality rates of 3.5% at the start of the project and 3.71% at the end.

While the effectiveness of surgical checklists has been tested in small-scale, controlled research projects and pilot studies, South Carolina’s project is the first of its kind in the United States to make a positive impact on patients’ health on a large scale.

Why checklists work

Researchers theorized that improvement in patient outcomes after using surgical checklists is due to better communication among members of the surgical team.

Checklists encourage clinical staffers to openly discuss the surgical plan, along with any concerns and safety risks. This makes the surgical team more aware of its role in preventing patient complications both during and after surgery.

As Thornton Kirby, the president and CEO of the South Carolina Hospital Association (which spearheaded the project), said, “The study validates what we hoped and believed from the outset – if you change the operating room culture of how you communicate and coordinate your efforts, you can produce better outcomes.”

If your hospital isn’t using some kind of checklist for surgeries, this is a good reason to get started. Not only are checklists simple to use, they help clinicians make sure they aren’t overlooking any details that could have a negative impact on a patients’ recovery.

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