title: Towards better patient safety in otolaryngology: characteristics of patient injuries and their relationship with items on the WHO Surgical Safety Checklist.
abstract: OBJECTIVE
  Increasing knowledge of factors contributing to medical adverse events has influenced the development of preventive policies and protocols, the WHO Surgical Safety Checklist being the most widely known. Despite growing evidence of the checklist's effectiveness in surgery, its role in preventing adverse events in otolaryngology is unclear. We assessed patient injury-contributing factors in otolaryngology and their relationship with WHO checklist items.
  
  
  METHODS
  A retrospective claim record study of national patient insurance charts in Finland.
  
  
  METHODS
  The records of all accepted patient injury claims in otolaryngology between 2001 and 2011 were searched and reviewed by two otolaryngologists. Operation-related injuries were evaluated in detail. Factors contributing to injury were identified, classified and compared with items on the WHO checklist. We also estimated whether the injury might have been prevented with a properly used checklist.
  
  
  RESULTS
  In the 10-year study period, 188 (84.3%) of the 223 patient injuries were associated with operative care. Of these, 142 (75.5%) occurred in the operation theatre, and in 121 cases (64.4%), technical error in performing surgery was the primary cause of injury. In 18 injuries (9.6%), the error corresponded to a checklist item. Nine injuries (4.8%) could have been prevented with a properly used checklist.
  
  
  CONCLUSIONS
  Patient injuries in otolaryngology are strongly related to operative care. The WHO checklist is one suitable tool for error prevention.
authors.affiliation: Department of Vascular Surgery, Turku University Hospital, Turku, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Helmiö
authors.affiliation: Helsinki City Health Centre, Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Blomgren
authors.affiliation: Helsinki City Health Centre, Helsinki, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Lehtivuori
authors.affiliation: Finnish Patient Insurance Centre, Helsinki, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Palonen
authors.affiliation: Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: L-M
authors.initials: LM
authors.lastname: Aaltonen
mesh_terms: D057189:Checklist; D005387:Finland; D006801:Humans; D007345:Insurance Claim Review; D019300:Medical Errors / Q000517:prevention & control*; D009313:National Health Programs; D010036:Otolaryngology / Q000592:standards*; D013506:Otologic Surgical Procedures / Q000009:adverse effects*; D061214:Patient Safety; D012189:Retrospective Studies