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Ontario Study: Checklists May Not Improve Patient Outcomes

Study finds no "measureable improvements" in surgical safety records.

Published: March 13, 2014

Do surgical checklists improve patient outcomes? Don't count on it, says a new study of nearly 100 Ontario-area hospitals that found no measurable evidence that the World Health Organization-designed safe surgery checklist program works. Researchers from University of Toronto hospitals compared surgery-related deaths or complications 3 months before hospitals began using a checklist program to 3 months after the checklist. They found no statistically significant differences in outcomes.

The study's lead author says the findings call into question earlier claims that hospitals could improve patient outcome improvements by using the surgical checklist were overstated. Meanwhile, WHO leaders say the new study shows the participating hospitals failed to properly implement the surgical safety checklist program.

The new study was published yesterday in the New England Journal of Medicine, which also published the 2009 study that found that the standardized checklist led to a 47% reduction in deaths associated with high-risk surgeries.

"What we found was making extraordinary improvements in patient safety is probably going to take a lot more work than the introduction of something like these safety checklists," says lead author David Urbach, MD, a general surgeon at the University Health Network in Toronto. Read more.

Dan O'Connor


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