Implementation of WHO Surgical Safety Checklist in Assessing Surgical Mortality, Morbidity and Length of Hospital Stay
Background: In the era of quality assurance, strategy development to overcome avoidable human errors has become imperative. One of the most important goals for healthcare organizations is patient safety. Studying of four pillars of safe surgical care: infection prevention, anaesthesia safety, team work and communication, and measurement of surgical capacity and outcomes resulted in the development of WHO Surgical Safety Checklist (SSC) in June 2008. The present study was conducted to assess the surgical morbidity, mortality, length of hospital stay and quality of life after routine implementation of the WHO Surgical Safety Checklist on patient’s undergoing major operative procedure.
Materials and Methods : This was a prospective study which included 50 cases (Group A) on which the checklist was applied and 50 controls (Group B) on which the checklist was not applied in the Department of General Surgery at Government Medical College and Rajindra Hospital, Patiala during the period of May 2019 to December 2020.
Results : The study has shown an overall decrease in complication rates from 58% to 22% after the implementation of the checklist. Wound discharge showed a decrease from 34% to 16% whereas rates of wound dehiscence decreased by 18% after the implementation of the checklist. Surgical Site Infection (SSI), one of the most common complications seen in surgical wards showed significant decrease with p-value = 0.037. Mortality rates also showed a decrease by 2% post-implementation of the checklist. The mean hospital stay, however, showed non-significant results with stay decreasing from 9.40 days to 8.70 days post-implementation. Successful communication was observed after checklist implementation (Anaesthesiologists: 78.12% vs. 93.75%; Surgeons: 88.46% vs. 94.87%; Circulating Nurses: 70.0% vs. 82.5%)
Conclusion: It can be concluded from our study that effective implementation of the checklist improves communication and teamwork, decreases the occurrence of adverse events both intra-operatively and post-operatively and subsequently improving patient’s quality of life.
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