UW is one of 8 hospitals worldwide to begin using surgical checklists

The University of Washington Medical Center is one of eight hospitals around the world test-driving a surgical checklist the World Health...
By Carol M. Ostrom
Seattle Times health reporter

The University of Washington Medical Center is one of eight hospitals worldwide to try out a World Health Organization checklist, left, for surgery. Surgeons read off the checklist, much like a pilot would go over a checklist before take-off.

The UW's participation was spearheaded by Dr. E. Patchen "Patch" Dellinger, vice chairman of its surgery department. The list includes simple safety checks before and after surgery that the WHO says could cut the rate of surgical complications in half, such as verifying the surgical site, the patient's known allergies and making sure nothing was left inside the patient's body.

The version being used by the UW also includes items from a statewide project to improve surgical care called the Surgical Care and Outcomes Assessment Program, or SCOAP, led by Dellinger's colleague, Dr. David Flum.

With $1.35 million from the state Life Sciences Discovery Fund, Flum is signing up hospitals around the state to collect and share details about what surgeons do in operating rooms and how patients do afterward, and to use checklists to improve. The Washington State Hospital Association says its members have expressed enthusiasm about using the checklist.

Developed by test pilots after a fiery crash in 1935 of a prototype for the plane that became the Boeing B-17 "Flying Fortress," checklists are now an accepted and necessary part of aviation, and have helped transform a once dicey, dangerous endeavor.

Flum fervently believes checklists can do the same for surgery. While patients may be more varied than planes, he believes that using a standardized checklist in surgery can catch the most common mistakes that can cascade into disastrous outcomes.

Preliminary results seem to bear that out. According to the WHO, data from the first 1,000 patients shows the checklist has nearly doubled the likelihood that patients will receive proven standards of surgical care.

According to the WHO, this has resulted in "substantial reductions in complications and deaths" among those patients. Final results on the impact of the checklist are expected in the next few months.

Other hospitals conducting pilot studies of the checklist include the University of Toronto; St. Mary's Hospital in London; the University of Auckland in New Zealand; Philippine General Hospital in Manila; Prince Hamza Hospital in Amman, Jordan; St. Stephen's Hospital in New Delhi; and the District Hospital in Ifakara, Tanzania.

xource