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Affiliation(s)
- J. Bergs
- Research Group Patient Safety & Health Economics, faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - J. Hellings
- Research Group Patient Safety & Health Economics, faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - I. Cleemput
- Research Group Patient Safety & Health Economics, faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - P. Simons
- Research Group Patient Safety & Health Economics, faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - Ö. Zurel
- Research Group Patient Safety & Health Economics, faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - S. Vertriest
- Research Group Patient Safety & Health Economics, faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - D. Vandijck
- Research Group Patient Safety & Health Economics, faculty of Business Economics, Hasselt University, Hasselt, Belgium
- Department of Public Health and Health Economics,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Bergs J, Hellings J, Cleemput I, Simons P, Zurel Ö, Vertriest S, Vandijck D. Surgical safety checklists : an update. Acta Chir Belg 2014; 114:219-224. [PMID: 26021414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Surgical safety checklists aim to improve patient safety by prompting the attention of the surgical team towards critical steps during the operation. The checklist's items are aimed to improve compliance with proven interventions, and to facilitate multidisciplinary communication and teamwork. Based on the current literature, corroborated by systematic reviews and meta-analysis, surgical safety checklists have a positive impact on communication and reduce postoperative complications including mortality. However, despite their effectiveness, the implementation of these checklists is not straightforward. Several determinants leading to behaviour were checklists are checked but not properly executed have been highlighted. As surgical safety checklists are in essence complex sociological interventions, they must be implemented accordingly. Key factors for the implementation of these checklists have been suggested in the literature, although, the most profound way of implementation remains unclear.
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Affiliation(s)
- J Bergs
- Research Group Patient Safety & Health Economics, faculty of Business Economics, Hasselt University, Hasselt, Belgium
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Bergs J, Hellings J, Cleemput I, Zurel Ö, De Troyer V, Van Hiel M, Demeere JL, Claeys D, Vandijck D. Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications. Br J Surg 2014; 101:150-8. [DOI: 10.1002/bjs.9381] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2013] [Indexed: 11/07/2022]
Abstract
Abstract
Background
The World Health Organization (WHO) surgical safety checklist (SSC) was introduced to improve the safety of surgical procedures. This systematic review evaluated current evidence regarding the effectiveness of this checklist in reducing postoperative complications.
Methods
The Cochrane Library, MEDLINE, Embase and CINAHL were searched using predefined inclusion criteria. The systematic review included all original articles reporting a quantitative measure of the effect of the WHO SSC on postoperative complications. Data were extracted for postoperative complications reported in at least two studies. A meta-analysis was conducted to quantify the effect of the WHO SSC on any complication, surgical-site infection (SSI) and mortality. Yule's Q contingency coefficient was used as a measure of the association between effectiveness and adherence with the checklist.
Results
Seven of 723 studies identified met the inclusion criteria. There was marked methodological heterogeneity among studies. The impact on six clinical outcomes was reported in at least two studies. A meta-analysis was performed for three main outcomes (any complication, mortality and SSI). Risk ratios for any complication, mortality and SSI were 0·59 (95 per cent confidence interval 0·47 to 0·74), 0·77 (0·60 to 0·98) and 0·57 (0·41 to 0·79) respectively. There was a strong correlation between a significant decrease in postoperative complications and adherence to aspects of care embedded in the checklist (Q = 0·82; P = 0·042).
Conclusion
The evidence is highly suggestive of a reduction in postoperative complications and mortality following implementation of the WHO SSC, but cannot be regarded as definitive in the absence of higher-quality studies.
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Affiliation(s)
- J Bergs
- Department of Patient Safety and Health Economics, Faculty of Business Economics, Hasselt, Belgium
| | - J Hellings
- Patient Safety Group, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - I Cleemput
- Department of Patient Safety and Health Economics, Faculty of Business Economics, Hasselt, Belgium
| | - Ö Zurel
- Department of Patient Safety and Health Economics, Faculty of Business Economics, Hasselt, Belgium
| | | | - M Van Hiel
- Operating Theatre, Imelda Hospital, Bonheiden, Belgium
| | - J-L Demeere
- Department of Anaesthesiology, Kliniek St Jan, Brussels, Belgium
| | - D Claeys
- Department of Surgery, AZ Maria Middelares, Ghent, Belgium
| | - D Vandijck
- Department of Patient Safety and Health Economics, Faculty of Business Economics, Hasselt, Belgium
- Department of Public Health and Health Economics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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