Massachusetts Patients Should Demand Surgical Safety Checklists

If you are traveling on an airplane, you can be comforted by the fact that the pilots and co-pilots run through pre-flight and pre-landing checklists designed to prevent accidents and injuries. So wouldn’t you think the same techniques would be used in hospitals for critical surgical procedures? Well. . . not necessarily.

In an article published in the New England Journal of Medicine today, researchers demonstrated that the use of a simple checklist for surgical procedures cuts the rate of complication by 36%. The checklist reduced the rate of infection, wrong site surgery, the need for re-operation, post-operative complications, and death. The study demonstrated improvements in each of the eight countries involved in the study. If implemented properly, the number of injuries and wrongful deaths caused by medical malpractice would decline.

The authors report that roughly half of surgical complications are avoidable. The authors utilized a 19-step checklist to improve verification, to require surgical team members to introduce themselves and share patient concerns, to verify antibiotic coverage, and to document concerns regarding the post-operative recovery period.  The first part of the list is designed to reduce wrong patient, wrong operation, wrong site complications which are still remarkably common. Requiring the team members to introduce themselves to each other increased teamwork and also reduced mistakes.

With such obvious improvements so readily available, one would think that hospitals and doctors would be jumping quickly onto this bandwagon. Not necessarily. Why not? Would a little more paperwork and a little extra time cut into profits? When patients’ lives, health and safety are at stake, one would hope that hospitals would instead rush to implement these guidelines immediately. Implementing checklists are clearly one way to reduce injuries, death, and medical malpractice claims.

What you can do: The 19-step checklist has been been published on-line by the World Health Organization. Print a copy for yourself, and if you are going to be having surgery, make sure your doctors use either your form, or are already using one just like it.


Demand improvements in the delivery of health care in Massachusetts. Health care costs are always in the news, and sadly it is usually the lawyers who get blamed for increasing the cost of everything.  The simple fact is that surgical mistakes, which are a leading cause of medical malpractice claims, are avoidable. Now there is proof that following a simple checklist immediately cuts the complication rate by over a third. Tell your legislators that uniform checklist requirements should be a matter of law. Demand operating room safety, which saves lives,
saves money, and reduces our taxes.

More Information

A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population, New England Journal of Medicine, January 2009

Use of simple OR checklist reduces surgery complications, Boston Globe, January 14, 2009

If you have concerns about surgical medical malpractice, the attorneys at the Boston injury firm of Breakstone, White & Gluck can evaluate your case. Please feel free to contact us for a free consultation. Our toll free number is 800-379-1244.

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