Surgical safety
Some surgical safety procedures have produced dramatic results at the nation’s Veterans Affairs hospitals.
It never hurts to double-check.
Some people who have had even minor surgery recently may have been surprised at some of the questions they were asked during the pre-op process. “So, we’re removing a cataract and implanting a lens in your LEFT eye, right?” “Today, we’re working on a break of the fifth metatarsal bone in your RIGHT foot, correct?”
A patient’s natural reaction might be to respond with another question — “Don’t you people already know this?” — but a new study shows that including patients and everyone else in the operating room in a surgical checklist process is a lifesaving practice.
The results of a three-year study conducted at Veterans Affairs hospitals were dramatic. Surgery deaths dropped by 18 percent at the hospitals where surgical teams developed a checklist and discussed the lists before and during each surgery. VA officials compared data from 74 hospitals trained in patient safety methods and 24 similar hospitals without that training. At hospitals that had implemented the training, the rate of surgical patients who died dropped from 17 per 1,000 patients to 14 per 1,000.
That’s 3 of 1,000 patients who should have no complaints about answering what may seem like some silly questions before surgery.
According to VA officials, the use of the checklist and the involvement of everyone in the operating room represents a significant shift in thinking, particularly for surgeons, who were accustomed to calling all the shots. It seems likely that the VA surgeons still have the last say in their operating rooms, but the study released this week should convince them that it doesn’t hurt to have other people watching their backs.
No matter how skilled or talented a professional is, everyone makes mistakes. When a surgeon makes a mistake, it can have serious or fatal consequences. If using a checklist and increasing communication with patients and the rest of the surgical team can reduce those mistakes, everyone benefits.
It’s a little surprising that such a simple step could have such dramatic results, but it’s all the more reason for surgeons and hospitals across the nation to note the VA study and consider some operational changes of their own.

