title: Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications, and unplanned readmissions in a pilot study in neurosurgery.
abstract: OBJECTIVE
  The World Health Organization's surgical safety checklist is designed to improve adherence to operating room safety standards, and its use has been shown to reduce complications among surgical patients. The objective of our study was to assess the impact of the implementation of the checklist on safety-related issues in the operating room and on postoperative adverse events in neurosurgery.
  
  
  METHODS
  From structured questionnaires delivered to operating room personnel, answers were analyzed to evaluate communication and safety-related issues during 89 and 73 neurosurgical operations before and after the checklist implementation, respectively. From the analyzed operations, 83 and 67 patients, respectively, were included in a retrospective analysis of electronic patient records to compare the length of hospital stay, reported adverse events, and readmissions. In addition, the consistency of operating room documentation and patient records was assessed.
  
  
  CONCLUSIONS
  Communication between the surgeon and the anesthesiologist was enhanced, and safety-related issues were better covered when the checklist was used. Unplanned readmissions fell from 25% to 10% after the checklist implementation (p = 0.02). Wound complications decreased from 19% to 8% (p = 0.04). The consistency of documentation of the diagnosis and the procedure improved. The use of the checklist improved safety-related performance and, contemporarily, reduced numbers of wound complications, and readmissions were observed.
authors.affiliation: Faculty of Medicine, University of Turku, Turku, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Lepänluoma
authors.forename: R
authors.initials: R
authors.lastname: Takala
authors.forename: A
authors.initials: A
authors.lastname: Kotkansalo
authors.forename: M
authors.initials: M
authors.lastname: Rahi
authors.forename: T S
authors.initials: TS
authors.lastname: Ikonen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D004282:Documentation / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000592:standards* / Q000706:statistics & numerical data; D010865:Pilot Projects; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014944:World Health Organization
keywords: Adverse event; WHO surgical safety checklist; checklist; communication; complications; neurosurgery; operating room teamwork; patient safety