World Health Organization Pushes for Safer Surgery

According to Margaret Chan, MD, director-general of WHO, "Preventable surgical injuries and deaths are now a growing concern." Estimates tell us that one half of surgery complications are preventable. The "Safe Surgery Saves Lives Initiative", first edition, is due for launch in 2008 following a thorough evaluation of pilot studies which show that the initiative will likely double the safety of surgical procedures through the implementation of a patient checklist - a standard developed for use in all health settings, in all parts of the world.

The Safe Surgery Saves Life Initiative involves 200 national medical societies and health ministries who have collaborated to set safety standards for patients and improve surgery outcomes worldwide. The program is led by Harvard School of Public Health.

Setting higher standards of surgical care has become a major issue as disparities are seen among low income populations and in areas where access to surgical facilities is limited. Coauthor, Atul Gawande, MD, MPH, a surgeon and professor at Harvard Medical School in Boston, Massachusetts explains, "Although there have been major improvements over the last few decades, the quality and safety of surgical care has been dismayingly variable in every part of the world. The Safe Surgery Saves Lives initiative aims to change this by raising the standards that patients anywhere can expect."

The World Health Organization has developed a three-part checklist for healthcare personnel, to be performed before a patient is placed under anesthesia, before a surgical incision is made, and before a patient leaves the operating room. The World Health Organization states that “Safety measures are inconsistently applied in surgery, even in sophisticated settings. Simple steps can reduce complication rates. For example, improving the timing and selection of antibiotics prior to skin incision can reduce the rate of surgical site infections by up to 50%”.

Surgical complications vary with the type of procedure being performed. Common problems include the formation of blood clots (deep vein thrombosis, or DVT), pneumonia, bleeding, reactions to anesthesia and infection. Even minor surgery can have adverse outcomes, and surgeons are continually looking for ways to ensure patient safety. According to the World Health Organization, “Successful implementation of the WHO Surgical Safety Checklist, and the potential to improve outcomes for patients around the world, will require adapting the Checklist to local routines and expectations. This will not be possible without sincere commitment of hospital administrators and policy-makers in the highest echelons of professional organizations and ministries of health”.

Preparing for surgery can help your doctor ensure the success of your operation and recovery. Discuss whether you should continue your prescription medication prior to surgery, including over the counter drugs and herbal supplements. Stop smoking at least two weeks before your operation. If there is a risk of significant blood loss during surgery, consider storing your own blood for transfusion, a procedure that can be performed up to four weeks prior to surgery. Make certain you discuss all of your existing health problems during your pre-operative visit. Send any recent blood tests or EKG’s to your doctor for comparison. Make a complete list of any food, medication or latex allergies.

For more information about what you need to know as a patient, visit Preparing for surgery. You can also find help and information at the resources below.

Safe Surgery Saves Life Initiative.
Questions to Ask Your Doctor and Your Surgeon