Variation in global uptake of the Surgical Safety Checklist

Area of Science:

• Global Surgery
• Patient Safety
• Health Systems Research

Background:

• The Surgical Safety Checklist (SSC) is a proven patient safety tool that enhances teamwork and adherence to perioperative practices, reducing mortality.
• Original pilot work on the SSC was published a decade ago, necessitating an update on its current global status.

Purpose of the Study:

• To determine the contemporary global prevalence of Surgical Safety Checklist (SSC) use.
• To identify predictors of SSC utilization across different countries and healthcare settings.

Main Methods:

• Analysis of pooled data from the GlobalSurg and Surgical Outcomes studies (2014-2016).
• Primary exposure: Human Development Index (HDI) of reporting countries.
• Generalized estimating equation used to assess differences in SSC use based on patient, facility, and national characteristics.

Main Results:

• Data from 85,957 patients across 1464 facilities in 94 countries were analyzed; average SSC use was 75.4%.
• SSC use was significantly lower in low HDI countries compared to very high HDI countries (OR 0.08).
• Lower SSC use was observed in urgent vs. elective operations in low HDI countries, for obstetrics/gynecology vs. abdominal surgery, and in countries where the official language was not a WHO official language.

Conclusions:

• While global SSC use is generally high, substantial variability persists.
• Targeted implementation and dissemination strategies are essential to address the observed disparities in SSC use worldwide.