Surgical Safety Checklists Did Not Substantially Improve Surgical Outcomes

David R. Urbach, M.D From the Institute for Clinical Evaluative Sciences Department of Surgery Institute of Health Policy, Management and Evaluation University of Toronto, the University Health Network Toronto, ON M5G 2C4, CanadaMedicalResearch.com Interview with:
David R. Urbach, M.D
From the Institute for Clinical Evaluative Sciences
Department of Surgery
Institute of Health Policy, Management and Evaluation
University of Toronto, the University Health Network
Toronto, ON M5G 2C4, Canada

MedicalResearch.com: What are the main findings of the study?

Dr. Urbach: After surgical safety checklists were adopted by hospitals in Ontario, surgical outcomes—death after surgery, complications, length of stay, readmissions—did not improve substantially.
MedicalResearch.com: Were any of the findings unexpected?

Dr. Urbach: These findings were unexpected because previous research suggested that there were large benefits from introducing surgical safety checklists. For example, the risk of death after surgery was reduced between 30% and 50% among early studies.

MedicalResearch.com: What should clinicians and patients take away from your report? 

Dr. Urbach: Improving surgical safety requires more than just introducing safety checklists. Meaningful improvements in safety will probably require comprehensive, team-based interventions that result in a lasting change in culture.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Urbach: We need to continue to explore how safety and quality can be improved in surgery. Checklists are an important part of this, but not sufficient by themselves to cause major improvements.

Citation:

 Introduction of Surgical Safety Checklists in Ontario, Canada

David R. Urbach, M.D., Anand Govindarajan, M.D., Refik Saskin, M.Sc., Andrew S. Wilton, M.Sc., and Nancy N. Baxter, M.D., Ph.D.

N Engl J Med 2014; 370:1029-1038

March 13, 2014DOI: 10.1056/NEJMsa1308261