Study Shows A Few Basic Steps Can Save Lives in the Operating Room

David Mittleman

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A new study released by the New England Journal of Medicine indicates that by merely following a 19-point checklist, surgical deaths and complications were reduced by over 40%. The study was conducted in eight cities worldwide, in both rural and urban hospitals and in low- and high-income areas. The surgical checklist, which is patterned after that involved with the aviation industry, takes only two minutes to complete and is designed to promote teamwork and organization. The steps are divided into three different time periods: prior to administering anesthesia, before skin incision, and before the patient leaves the operating room. Furthermore, the checklist does not involve the use of costly technology; rather, it costs practically nothing to properly administer and can potentially save tens of thousands of lives and over $20 billion in medical costs yearly. The goal is to have all hospitals in the U.S. try the checklist by April 1 of this year, and several other countries have plans to implement the checklist in their hospitals.

However, after glancing at the list, one must question what makes this list so remarkable. After all, the list includes several common sense steps one would expect (and hope) to be taken if they were going into any minor or major surgery, including: confirming the identity of the patient, marking the surgical site, making any known allergies aware to all members of the surgical team, introducing each member of the surgical team, making sure enough blood and antibiotics are on-site, and making a surgical count of sponges, needles, and other instruments after completion of the procedure. Does the World Health Organization really need to issue a checklist for these steps? Shouldn’t these be steps doctors and nurses take regardless to protect themselves, the hospital and the patient?