Dear Colleagues,

We are proud to share yet another example of how UHN is achieving global impact. Today, an international pilot study co-authored by UHN's own Drs. Bryce Taylor and Richard Reznick has found that using a Surgical Patient Safety Checklist reduces surgical complications and mortality by more than one third. The study appears online in the New England Journal of Medicine.

First, a bit of background: TGH and seven hospitals from New Delhi, India; Amman, Jordan; Auckland, New Zealand; Manila, Philippines; Ifakara, United Republic of Tanzania; London, UK; and Seattle, USA were selected by the World Health Organization (WHO) and the Harvard School of Public Health to pilot a Surgical Patient Safety Checklist. Interestingly, the Checklist was influenced by checklists used in the airline industry to reduce the incidence of airline errors.

TGH was the only hospital in Canada and one of only two hospitals in North America involved in the pilot study. As you know, UHN's Surgical Program is one of the largest in Canada. Last year, we performed an incredible 23,000 inpatient and outpatient surgeries under Dr. Taylor's leadership.

We know from previous studies that major complications occur in 3 to 16 percent of inpatient surgeries and permanent disability or death rates occur in 0.4 to 0.8 percent. Inconsistent approaches to surgery can also lead to adverse events. Using the Checklist at three critical points during surgery (prior to anesthesia, immediately prior to incision, and prior to patient exiting the operating room), a member of the surgical team verbally confirms the completion of each step for infection prophylaxis, anesthesia safety and other essential steps in surgery (ex. confirming that the surgery site is marked, surgical equipment is sterilized, etc).

Dr. Taylor sums up the Checklist nicely: "Like an airline pilot, the surgeon is only one member of an entire surgical team. Using the Checklist, we can improve communications during surgery to make sure everyone is on the same page and to use proven standards in every single operation to reduce the risks to patients,"

For more information about the WHO initiative visit: http://www.who.int/patientsafety/safesurgery/en/index.html

Bob Bell and Catherine Zahn

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