{"id":1407,"date":"2014-03-12T00:00:00","date_gmt":"2014-03-12T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/introduction-of-surgical-safety-checklists-in-ontario-canada\/"},"modified":"2023-06-14T20:00:26","modified_gmt":"2023-06-15T00:00:26","slug":"introduction-of-surgical-safety-checklists-in-ontario-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/introduction-of-surgical-safety-checklists-in-ontario-canada\/","title":{"rendered":"Introduction of surgical safety checklists in Ontario, Canada"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Evidence from observational studies that the use of surgical safety checklists results in striking improvements in surgical outcomes led to the rapid adoption of such checklists worldwide. However, the effect of mandatory adoption of surgical safety checklists is unclear. A policy encouraging the universal adoption of checklists by hospitals in Ontario, Canada, provided a natural experiment to assess the effectiveness of checklists in typical practice settings.<\/p>\n<p><strong>Methods<\/strong> &#x2014; We surveyed all acute care hospitals in Ontario to determine when surgical safety checklists were adopted. Using administrative health data, we compared operative mortality, rate of surgical complications, length of hospital stay, and rates of hospital readmission and emergency department visits within 30 days after discharge among patients undergoing a variety of surgical procedures before and after adoption of a checklist. <\/p>\n<p><strong>Results<\/strong> &#x2014; During 3-month periods before and after adoption of a surgical safety checklist, a total of 101 hospitals performed 109,341 and 106,370 procedures, respectively. The adjusted risk of death during a hospital stay or within 30 days after surgery was 0.71% (95% confidence interval [CI], 0.66 to 0.76) before implementation of a surgical checklist and 0.65% (95% CI, 0.60 to 0.70) afterward (odds ratio, 0.91; 95% CI, 0.80 to 1.03; P = 0.13). The adjusted risk of surgical complications was 3.86% (95% CI, 3.76 to 3.96) before implementation and 3.82% (95% CI, 3.71 to 3.92) afterward (odds ratio, 0.97; 95% CI, 0.90 to 1.03; P = 0.29).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Implementation of surgical safety checklists in Ontario, Canada, was not associated with significant reductions in operative mortality or complications.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Evidence from observational studies that the use of surgical safety checklists results in striking improvements in surgical outcomes led to the rapid adoption of such checklists worldwide. However, the effect of mandatory adoption of surgical safety checklists is unclear. A policy encouraging the universal adoption of checklists by hospitals in Ontario, Canada, provided [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,25],"migration-helper-qa-sample-set":[],"class_list":["post-1407","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-surgery"],"acf":{"citation":"Urbach DR, Govindarajan A, Saskin R, Wilton AS, Baxter NN. <em>N Engl J Med.<\/em> 2014; 370(11):1029-38. Epub 2014 Mar 13.","source_url":"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMsa1308261#t=article","ices_scientist":[1343,1243,1177,1360],"site":[6733],"research_program":[6741],"news_release":[7335],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"85DEA934-3EF1-4C87-9A5C-BFB7D49E7B9B","sitecore_item_name":"Introduction-of-surgical-safety-checklists","sitecore_field_values":"{\n  \"Title\": \"Introduction of surgical safety checklists in Ontario, Canada\",\n  \"Short title\": \"Introduction of surgical safety\",\n  \"Summary\": null,\n  \"Citation\": \"<p>Urbach DR, Govindarajan A, Saskin R, Wilton AS, Baxter NN. <em>N Engl J Med.<\/em> 2014; 370(11):1029-38. Epub 2014 Mar 13.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Evidence from observational studies that the use of surgical safety checklists results in striking improvements in surgical outcomes led to the rapid adoption of such checklists worldwide. However, the effect of mandatory adoption of surgical safety checklists is unclear. A policy encouraging the universal adoption of checklists by hospitals in Ontario, Canada, provided a natural experiment to assess the effectiveness of checklists in typical practice settings.<\/p>n<p><strong>Methods<\/strong> &mdash; We surveyed all acute care hospitals in Ontario to determine when surgical safety checklists were adopted. Using administrative health data, we compared operative mortality, rate of surgical complications, length of hospital stay, and rates of hospital readmission and emergency department visits within 30 days after discharge among patients undergoing a variety of surgical procedures before and after adoption of a checklist. <\/p>n<p><strong>Results<\/strong> &mdash; During 3-month periods before and after adoption of a surgical safety checklist, a total of 101 hospitals performed 109,341 and 106,370 procedures, respectively. The adjusted risk of death during a hospital stay or within 30 days after surgery was 0.71% (95% confidence interval [CI], 0.66 to 0.76) before implementation of a surgical checklist and 0.65% (95% CI, 0.60 to 0.70) afterward (odds ratio, 0.91; 95% CI, 0.80 to 1.03; P = 0.13). The adjusted risk of surgical complications was 3.86% (95% CI, 3.76 to 3.96) before implementation and 3.82% (95% CI, 3.71 to 3.92) afterward (odds ratio, 0.97; 95% CI, 0.90 to 1.03; P = 0.29).<\/p>n<p><strong>Conclusions<\/strong> &mdash; Implementation of surgical safety checklists in Ontario, Canada, was not associated with significant reductions in operative mortality or complications.<\/p>n<p><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMsa1308261#t=article\" title=\"External link to full article\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{9F514AF9-2526-48FE-8414-54C443CF99AD}|{8E23A87E-6B3D-4205-9D89-24C7C045D93A}|{53FC76BF-785B-4A1C-805E-1E03634BE9CF}\",\n  \"Related Products\": \"<h2>News Release<\/h2>rn<h3><a href=\"~\/link.aspx?_id=015CD1974B644D1881E25E7C4B43FC89&amp;_z=z\">Study shows introduction of surgical safety checklists in Ontario have not reduced post-operative mortality or complications<\/a><\/h3>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{44155080-6CB5-428D-9E38-9693CAD11DD3}|{A241E749-6A25-4A79-9891-DDB1C658A131}|{73B9FD95-5453-4FBA-B02E-CD2911B86ACD}|{826B4C0C-81D4-49A9-837F-DB6413A32E7C}\",\n  \"Posted Date\": \"20140312T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2014\/January\/Introduction-of-surgical-safety-checklists"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Introduction of surgical safety checklists in Ontario, Canada<\/title>\n<meta name=\"description\" content=\"Background &#x2014; 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