Study of 357 hospitals in 58 countries: those using the WHO Safe Surgery Checklist had 38% lower odds of death https://t.co/XXhGgBEAHH
— Atul Gawande (@Atul_Gawande) July 1, 2016
GlobalSurg 1 reported a strong association between use of the surgical safety checklist and lower mortality after emergency abdominal surgery. George Molina from Atul Gawande’s Ariadne Labs has posted a thoughtful piece on these findings. Here are some highlights.
What better way to study these difficult research questions about the quality of and barriers to surgical safety checklist use in diverse environments than to partner with an international collaborative similar to GlobalSurg? Some of the common challenges in projects that involve multiple institutions and multiple countries are lack of local champions and local buy-in of key stakeholders, including administrators, surgeons, anesthesiologists/anesthetists, nurses and others. Global collaborations like GlobalSurg are powerful because they have the potential to generate enthusiasm and cooperation among investigators from different settings who are known and respected in their local institutions. Furthermore, international collaborations are unique because they encourage local investigators to participate in a global project that has the potential to increase the generalizability of findings.
Readers of small prospective cohort studies may argue that findings that are contrary to what is expected are simply not generalizable to their patients, practice, or hospital. Although no study is immune to this argument, an international collaboration that reported on more than 10,000 patients from 357 centers located in 58 countries is quite an achievement and whose findings cannot be easily dismissed due to lack of generalizability.
There is still much work to be done to ensure that surgical safety checklists are used, and used well every time an operation is performed around the world. Global surgical collaborations like GlobalSurg can serve an important role in studying difficult research questions regarding the use of surgical safety checklists, and can foster a greater awareness and enthusiasm for the importance of creating a culture of patient safety through using surgical checklists worldwide.
Dr. George Molina is a former post-doctoral research fellow at Ariadne Labs and currently a resident in general surgery at Massachusetts General Hospital (MGH). He, along with two other investigators at MGH, participated in the GlobalSurg study published in BJS.