| NMCSD Leads WHO Surgical Checklist

News Courtesy of: Communication Specialist 2nd Class Alexander Ameen


SAN DIEGO (January 1, 2009) – Naval Medical Center San Diego (NMCSD) recently implemented a pilot program to test a new surgical checklist aimed at improving communication and providing a more comprehensive way for surgical teams to perform operations.


The checklist is based on a new format developed by the Institute for Healthcare Improvement (IHI) at the request of the World Health Organization (WHO).


Capt. (Dr.) Jose Acosta, Director of Surgical Services at NMCSD, said two departments at the hospital are already using the checklist.


"I attended the IHI conference in December where the checklist was introduced," Acosta said. "As soon as I got back to San Diego we put a team together to assess exactly how we would implement [the checklist] ASAP."


Acosta said NMCSD had a "Surgery Time Out" system in place, which allowed a surgical team to take a moment before making an incision to double-check their information, but the new checklist is much more thorough.


The standard WHO check lists includes 19 steps such as making sure the patient has identified himself and given consent, confirming all surgical team members have introduced themselves by name and role, and confirming instrument, sponge and needle counts are correct. The checklist can be modified to better suit the needs of individual facilities.


"We did customize the checklist a little, adding steps such as making sure the proper equipment is available and administering prophylaxis to prevent blood clots," Acosta said.


The WHO checklist was developed in response to statistics showing that out of more than 234 million people world wide that will have major operations this year, approximately one percent will die from complications that could have been prevented.

According to a special article recently appearing in The New England Journal of Medicine, eight hospitals in eight cities around the globe, representing a variety of economic circumstances and diverse populations of patients, participated in testing the new checklist between October 2007 and September 2008.


Use of the checklist in these eight hospitals was associated with a reduction of the death rate from surgery by almost half and the reduction of complications by more than a third.


For more information on NMCSD, visit http://www.med.navy.mil/sites/nmcsd.