Reducing surgical mortality in Scotland by use of the WHO Surgical Safety Checklist

• Published in: British journal of surgery 2019-07, Vol.106 (8), p.1005-1011
• Main Authors: Ramsay, G., Haynes, A. B., Lipsitz, S. R., Solsky, I., Leitch, J., Gawande, A. A., Kumar, M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Checklist - methods; Child; Child, Preschool; Female; Hospital Mortality; Humans; Infant; Infant, Newborn; Male; Middle Aged; Mortality; Patient Safety; Perioperative Care - methods; Perioperative Care - standards; Scotland - epidemiology; Surgical Procedures, Operative - methods; Surgical Procedures, Operative - mortality; Surgical Procedures, Operative - standards; World Health Organization; Young Adult
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.11151

Background The WHO Surgical Safety Checklist has been implemented widely since its launch in 2008. It was introduced in Scotland as part of the Scottish Patient Safety Programme (SPSP) between 2008 and 2010, and is now integral to surgical practice. Its influence on outcomes, when analysed at a population level, remains unclear. Methods This was a population cohort study. All admissions to any acute hospital in Scotland between 2000 and 2014 were included. Standardized differences were used to estimate the balance of demographics over time, after which interrupted time‐series (segmented regression) analyses were performed. Data were obtained from the Information Services Division, Scotland. Results There were 12 667 926 hospital admissions, of which 6 839 736 had a surgical procedure. Amongst the surgical cohort, the inpatient mortality rate in 2000 was 0·76 (95 per cent c.i. 0·68 to 0·84) per cent, and in 2014 it was 0·46 (0·42 to 0·50) per cent. The checklist was associated with a 36·6 (95 per cent c.i. –55·2 to –17·9) per cent relative reduction in mortality (P