Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in North America

Abstract

Objective: To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications.

Study design: Before-and-after intervention study.

Animals: Client-owned dogs (n = 633) and cats (n = 44).

Methods: Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC^- ) followed by 75 SSC^- surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC⁺ ) and an observer were used and 277 SSC⁺ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication.

Results: There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications.

Conclusion: Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications.

Clinical significance: This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.