title: Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist.
abstract: OBJECTIVE
  To examine whether the use of a surgical safety checklist (SSC) could reduce the incidence of complications after small animal surgery.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Client-owned dogs and cats (n = 520).
  
  
  METHODS
  Consecutive cases were enrolled in the study, the first 300 cases without implementation of the surgical checklist (SSC-), followed by 220 cases with implementation of the checklist (SSC+). The checklist was adapted from the WHO surgical checklist and consisted of three different check points: (1) before induction of anaesthesia (sign in), (2) before surgical incision (time out), and (3) before recovery (sign out). In-hospital outcomes were prospectively recorded, and complications within 6 weeks were retrospectively recorded by reviewing medical records and by telephone interviews with owners. The severity of each recorded complication was graded as minor, moderate, or severe. Comparisons were made between SSC- and SSC+ outcomes.
  
  
  RESULTS
  There were significantly more complications in SSC- animals than SSC+ animals (SSC- 52/300 vs. SSC+ 15/220, P = .0003). There was a significantly higher frequency of SSI (P = .045) and wound healing complications (P = .0006) for SSC- animals than SSC+ animals.
  
  
  CONCLUSIONS
  The frequency and severity of postoperative complications was significantly decreased after introduction of a surgical checklist. All veterinary hospitals should consider using a surgical checklist. Compliance with implementation of the checklist is important for success.
authors.affiliation: Department of Clinical Sciences, University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Bergström
authors.affiliation: University Animal Hospital, University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Dimopoulou
authors.affiliation: University Animal Hospital, University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: Mikaela
authors.initials: M
authors.lastname: Eldh
mesh_terms: D000818:Animals; D002415:Cats / Q000601:surgery*; D057189:Checklist / Q000706:statistics & numerical data; D004285:Dogs / Q000601:surgery*; D005260:Female; D008297:Male; D061214:Patient Safety / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000517:prevention & control / Q000662:veterinary*; D011446:Prospective Studies