Safe Surgery Saves Lives

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Safe Surgery Saves Lives

• William R. Berry, MD, MPH, FACS
• Cambridge, MA
• August 2008

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Bringing Surgery into the Light

• Unrecognized as public health issue
• More surgeries are done each year than there are
  births.
• Surgery is different
• Lack of data on surgery and outcomes
• Failure to use existing safety know how

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  Mean Estimated Surgical Rate (per 100,000 population) Estimated volume of surgery ( of total) Percent of global population
Poor Expenditure Countries (per capita total expenditure on health 100 US) 326 7,258,507 (3.2) 34.8
Low Expenditure Countries (per capita total expenditure on health 101-400 US) 2,190 50,126,749 (21.8) 35.0
Middle Expenditure Countries (per capita total expenditure on health 401-1000 US) 4,169 34,636,447 (15.0) 14.6
High Expenditure Countries (per capita total expenditure on health gt1000 US) 11,129 138,090,970 (60.0) 15.6
Total Global Volume of Surgery   230,112,673  
Average Surgical Rate 3,987    
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1999 Utah/Colorado study
Review of charts from 15,000 admissions to 28
hospitals in 1992
Surgery 1999126(1)66-75
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Safer Surgery Saves Lives

• First Consultation
• Geneva Switzerland 11-12 January 2007
• Over 50 participants from around the globe
• Reviewed possible work in four areas
• Clean Surgery
• The surgical environment
• Safe Anesthesia
• The surgical provider
• The safe surgical team
• Measuring the safety of surgery
• A Surgical Vital Sign

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How the Pilot's Checklist Came About
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The Surgical Checklist

• Simple
• Universal
• Easily understood
• Saving lives and decreasing complications

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Preliminary Pilot Site Results
Site Cases Use of Pulse Oximeter Time Out to Confirm Site/Pt Abx _at_ 0-60 mins IV Access gt500 cc EBL
1 377 100 100 98 93
2 317 97 8.8 52 73
3 232 96 100 34 7
4 481 77 22 25 49
5 338 97 50 75 80
6 524 99 99 48 32
7 519 100 99 78 67
8 446 99 17 18 73
Total Cases 3234
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Preliminary Pilot Site Results
Site Infection Complication Death
1 1.1 7.2 0.4
2 1.3 5.3 0
3 23.8 24.2 1.7
4 3.7 9.8 3.5
5 6.5 14 0
6 9.4 12 2.1
7 3.1 6.4 1.0
8 4.0 6.3 1.3
Total Cases 3234
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http//www.who.int/patientsafety/safesurgery/en
/index.html