title: [Establishment of a modified surgical safety checklist for the neurosurgical patient: Initial experience in 400 cases].
abstract: BACKGROUND
  Adverse events during diagnostic and therapeutic procedures and medical errors associated with them are an important source of patient morbidity. In an attempt to reduce these, the WHO has proposed a series of measures applicable to medical and surgical patients. Within these last ones is the surgical safety checklist (SSC), a brief questionnaire that does not increase healthcare costs, is accessible to all surgical centres and can be adapted to each specific environment.
  
  
  OBJECTIVE
  To evaluate the effectiveness of establishing a modified WHO SSC on the safety and quality of care of the neurosurgical patient in a third-level university hospital.
  
  
  METHODS
  The SSC was applied to a series of 400 scheduled surgeries between May 2009 and May 2010. During the initial 6 months, 183 surgical procedures were performed (group 1). All adverse events detected in this period were studied with a root-cause analysis methodology (RCA) and, according to its results, corrective measures were introduced. After that, 217 procedures were performed (group 2).
  
  
  RESULTS
  We recorded 51 events in 44 surgeries (11%). We were able to correct 88.23% of them before surgery was initiated, avoiding any consequence in the normal management of the case. In Group 1, incidents were noted in 15.3% of the procedures. The RCA suggested that 37.8% of the events had a human cause, followed by problems related to material resources and equipment in 29.7%, and organisational reasons in 21.6%. Incidence of events was reduced in group 2 to 7.4% (P=.01). Corrective measures prevented the appearance of perioperative events in 1 out of 13 procedures.
  
  
  CONCLUSIONS
  The SSC is an effective tool for improving safety in neurosurgical patients, which can be established in surgical departments of any hospital without increasing healthcare costs or operative time.
authors.affiliation: Servicio de Neurocirugía, Unidad de Raquis Quirúrgico, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.
authors.forename: Rousinelle
authors.initials: R
authors.lastname: Da Silva-Freitas
authors.forename: Ruben
authors.initials: R
authors.lastname: Martín-Laez
authors.forename: César Baldomero
authors.initials: CB
authors.lastname: Madrazo-Leal
authors.forename: Maikal
authors.initials: M
authors.lastname: Villena-Martin
authors.forename: Idoya
authors.initials: I
authors.lastname: Valduvieco-Juaristi
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Martínez-Agüeros
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vázquez Barquero
mesh_terms: D057189:Checklist; D006801:Humans; D015994:Incidence