Three central problems in surgical safety:
- Unrecognized as a public health issue
- Lack of data on surgery and outcomes
- Failure to use existing safety know-how
Unrecognized as a public health issue
- Known surgical complications of 3-16%
- Known death rates of 0.4-0.8%
- At least 7 million disabling complications, including 1 million deaths- worldwide each year
- Burden of surgical disease is increasing worldwide
Lack of data on surgery and outcomes
- Improvements in maternal mortality depend on routine surveillance
- Menace of HAI can be curbed with data of surgery
- Such surveillance is lacking for surgical care
Failure to use existing safety know-how
- High rates of preventable surgical site infection result from inconsistent timing of antibiotic prophylaxis
- Anesthetic complications are 100-1000x higher in countries that do not adhere to monitoring standards
- Wrong-patient, wrong-site operations persist despite high publicity of such events
The Safe Surgery Saves Lives:
- Promotion of surgical safety as a public health issue
- Creation of a checklist to improve the standards of surgical safety
- Collection of “Surgical Vital Statistics”
10 objectives for Safe Surgery:
- The team will operate on the correct patient at the correct site.
- The team will use methods known to prevent harm from administration of anesthetics, while protecting the patient from pain.
- The team will recognize and effectively prepare for life-threatening loss of airway or respiratory function.
- The team will recognize and effectively prepare for risk of high blood loss.
- The team will avoid inducing an allergic or adverse drug reaction for which the patient is known to be at significant risk.
- The team will consistently use methods known to minimize the risk for surgical site infection.
- The team will prevent inadvertent retention of instruments or sponges in surgical wounds.
- The team will secure and accurately identify all surgical specimens.
- The team will effectively communicate and exchange critical information for the safe conduct of the operation.
- Hospitals and public health systems will establish routine surveillance of surgical capacity, volume and results.
Goals of the Safe Surgery Saves Lives program
- Enroll 250 hospitals in the program
- Enroll hospitals in countries representing one fourth of the world’s population.
- Collect surgical vital statistics for one country in each WHO region.
- 234 million people are operated on each year, and >1 million of these individuals die from complications.
- At least ½ are avoidable with the Checklist.