WHO’s life-saving surgical checklist poorly adopted in low-income countries

Adoption of the World Health Organization’s surgical checklist has been spotty, according to a new report. The WHO Surgical Safety Checklist is a list of 19 questions, some of which are as elemental as making sure the right patient is on the table, the incision site is correctly marked, and anesthetics, oxygen, and transfusion blood are present. Previous research has shown that the checklist can significantly reduce unnecessary death and injury associated with surgical procedures.

The report was developed by Ariadne Labs, a joint health system innovation center at Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital, and Lifebox, a non-profit devoted to safer surgery and anesthesia in low-resource countries. The chair of Lifebox is Atul Gawande, professor in Harvard Chan School’s Department of Health Policy and Management.

For more than a decade, WHO has advocated that the checklist be used by every hospital worldwide. According to the report, surgical checklist use falls far short of universal adoption. Although a checklist is used in 90% of surgeries in wealthy countries, a list is used around a third of the time in poor countries.  A New York Times article on January 15, 2020 mentioned a few of the factors that the study blames for low adoption, including surgeons who resent the implication that they may make dangerous mistakes, lax enforcement by hospital administrators, and the powerlessness of nurses in some cultures.

Read the New York Times article: Where Surgeons Don’t Bother With Checklists