A Systematic Review of the Effectiveness, Compliance, and Critical Factors for Implementation of Safety Checklists in Surgery

  title={A Systematic Review of the Effectiveness, Compliance, and Critical Factors for Implementation of Safety Checklists in Surgery},
  author={Annegret Borchard and David L. B. Schwappach and Aline Barbir and Paula Bezzola},
  journal={Annals of Surgery},
Objective:A systematic literature review was conducted to assess the effectiveness of, compliance with, and critical factors for the implementation of safety checklists in surgery. Background:With the aim of increasing patient safety, checklists have gained growing attention. Information about effectiveness, compliance, and critical factors for implementation is crucial for whether and which of the available instruments to use. Data Sources:Medline including Premedline (OvidSP), Embase, and… 

Do Safety Checklists Improve Teamwork and Communication in the Operating Room? A Systematic Review

Evidence suggests that safety checklists improve the perceived quality of OR teamwork and communication and reduce observable errors relating to poor team skills and this may be one mechanism through which patient outcomes are improved.

Effect of Using a Safety Checklist on Patient Complications after Surgery: A Systematic Review and Meta-analysis

Not the lack of randomized controlled trials, synthesis of the existing body of evidence suggests a relationship between checklist use in surgery and fewer postoperative complications.

Effect of the surgical safety checklist on provider and patient outcomes: a systematic review

There is a scarcity of research that examines how the surgical safety checklist is completed and how this influences safety outcomes, and a clearer positive relationship was observed concerning the SSC’s influence on provider outcomes compared with patient outcomes (complications and mortality), as well as related moderators.

Implementation of safety checklists in surgery: a realist synthesis of evidence

Two consequential findings have emerged through this realist synthesis of the evidence of implementation interventions to improve adherence to the use of safety checklists in surgery: First, the sustained use of surgical checklists is discipline-specific and is more successful when physicians are actively engaged and leading implementation.

A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery.

All quantitative and mixed-methods study results showed a significant positive effect on SSC compliance and additional research is needed to address SSC Compliance measures globally and outcomes in developing countries.

Barriers and facilitators related to the implementation of surgical safety checklists: a systematic review of the qualitative evidence

A pragmatic overview of the user-related barriers and facilitators upon which theories, hypothesising potential change strategies and interactions, can be developed and tested empirically is provided.

A meta-analysis of the efficacy of preoperative surgical safety checklists to improve perioperative outcomes.

There is sufficient RCT evidence to suggest that SSCs decrease hospital mortality and surgical outcomes in tertiary and community hospitals, however, randomised evidence of the efficacy of the SSC at rural hospital level is absent.

Reducing the Burden of Surgical Harm: A Systematic Review of the Interventions Used to Reduce Adverse Events in Surgery

Only a small cohort of medium- to high-quality interventions effectively reduce surgical harm and are feasible to implement are reported.

Compliance with the surgical safety checklist in Switzerland: an observational multicenter study based on self-reported data

The results of this study indicate that the overall application of the surgical safety checklist in Switzerland can be considered high, although the completeness, especially of the Sign Out section, could be improved.



Information Transfer and Communication in Surgery: A Systematic Review

A systematic review of published literature to gain a better understanding of interprofessional information transfer and communication in hospital setting in the field of surgical and anesthetic care found uses of standardized communication through checklist, proformas, and technology innovations have improved the ITC process with an effect on clinical and patient outcomes.

Effective surgical safety checklist implementation.

Effect of A 19-Item Surgical Safety Checklist During Urgent Operations in A Global Patient Population

Implementation of the WHO Surgical Safety Checklist was associated with a greater than one-third reduction in complications among adult patients undergoing urgent noncardiac surgery in a diverse group of hospitals.

Prevention of Surgical Malpractice Claims by Use of a Surgical Safety Checklist

Nearly one-third of all contributing factors in accepted surgical malpractice claims of patients that had undergone surgery might have been intercepted by using a comprehensive surgical safety checklist, which might have prevented 40% of deaths and 29% of incidents leading to permanent damage.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.

Development and validation of the SURgical PAtient Safety System (SURPASS) checklist

The SURPASS checklist is the first validated patient safety checklist for the entire surgical pathway and can be applied in clinical practice relatively simply.

Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses

  • A. Stang
  • Psychology
    European Journal of Epidemiology
  • 2010
The quality assessment of non-randomized studies is an important component of a thorough meta-analysis of non randomized studies and can dramatically influence the interpretation of meta-analyses, and can even reverse conclusions regarding the effectiveness of an intervention.

Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention

Improvements in postoperative outcomes were associated with improved perception of teamwork and safety climate among respondents, suggesting that changes in these may be partially responsible for the effect of the checklist.

The SURgical PAtient Safety System (SURPASS) checklist optimizes timing of antibiotic prophylaxis

The use of the SURPASS checklist leads to better compliance with regard to the timing of antibiotic prophylaxis administration, and the proportion of patients that did not receive antibiotics until after the incision decreased significantly.

Use of the WHO surgical safety checklist in trauma and orthopaedic patients

Checklist use was not associated with a significant reduction in early complications and mortality in patients undergoing orthopaedic surgery, but education programs can significantly increase accurate use and staff perceptions following implementation.