New Study Questions Efficacy of Surgical Safety Checklists

Staff Writer | April 7th, 2014

surgery errorsThe New England Journal of Medicine recently published a study concerning surgery errors that showed “Implementation of surgical safety checklists in Ontario, Canada, was not associated with significant reductions in operative mortality or complications.”

The authors of the study examined cases from three months before and three months after implementation of mandatory surgical checklists. The analysts looked at 109,341 procedures before and 106,370 after the safety checklist was implemented at 101 hospitals in the Ontario area.

The researchers reported “the adjusted risk for death during hospitalization or 30 days after surgery decreased from 0.71% (95% confidence interval [CI], 0.66% – 0.76%) before implementation to 0.65% (95% CI, 0.60% – 0.70%) after surgery but did not reach statistical significance.”

They also indicated, “The adjusted risk for surgical complications decreased from 3.86% (95% CI, 3.76% – 3.96%) before implementation to 3.82% (95% CI, 3.71% – 3.92%) after surgery, still without statistical significance.”

The only statistically significant change was the length of stay and emergency room visits within 30 days of a patient’s procedure. The amount of time patients’ stayed in the hospital decreased from 5.11 to 5.07 days after the surgical safety checklists were implemented, and the percentage of return emergency visits decreased 1.94 percent to 1.78.

However, “They actually found increases in the adjusted risks for deep venous thrombosis and ventilator use.” Medscape reported.

The authors of the study “adjusted for age, sex, whether a procedure was an emergency or elective and inpatient or ambulatory, and other variables.”

Dr. Atul Gawande from Harvard Medical School and Harvard School of Public Health, who was a senior member on the 2009 study that inspired hospitals throughout the world to think about utilizing surgical safety checklists, told Medscape Medical News, “The idea that you could measure just 3 months after you’ve done an implementation, and expect that everywhere has adopted and adopted well, is pretty unlikely. It’s a bit of a premature study.”

An earlier study shows different results

According to the World Health Organization, “At least half a million deaths per year would be preventable with effective implementation of the WHO Surgical Safety Checklist worldwide.”

During the pilot study conducted in the Netherlands from 2007 to 2009, use of a checklist indicated complications during surgery were reduced by more than one-third and a reduction in deaths from 1.5 percent to 0.8 percent – an almost 50 percent decrease.

Surgery errors and medical malpractice

The goal of surgical checklists is to help ensure patients get a high quality standard of care. The reality is many medical facilities that are mandated to use this important checklist may not enforce its use efficiently, which puts patients at risk.

If you or someone you love has suffered injuries from surgical errors, you may be entitled to monetary damages for present, past, and future medical expenses as well as lost income, pain, suffering, and other losses.

To discuss your rights to legal action and other options with a NY medical malpractice attorney, contact The Sanders Firm for a free case evaluation. Our experienced team of attorneys can answer your questions and provide suggestions for your best course of action. Call toll-free 1.800.FAIR.PLAY.


  1. The New England Journal of Medicine - Introduction of Surgical Safety Checklists in Ontario, Canada, http://www.nejm.org/doi/full/10.1056/NEJMsa1308261

  2. World Health Organization - New scientific evidence supports WHO findings: a surgical safety checklist could save hundreds of thousands of lives, http://www.who.int/patientsafety/safesurgery/checklist_saves_lives/en/

  3. Medscape - Surgical Safety Checklist Use Shows Slow Progress in Ontario, http://www.medscape.com/viewarticle/821910