INDUSTRY INSIGHT
VETERINARY SERVICES
SPONSORED CONTENT
SURGICAL SAFETY CHECKLISTS
A Simple Solution to a Complex Problem
O
Michael Kraun, DVM
Diplomate, American College of Veterinary Surgeons – Small Animal
Pittsburgh Veterinary Specialty and Emergency Center,
a BluePearl Veterinary Partners Hospital
ver the past several decades, the field of medicine has
from the around the globe. The goal of the meeting was to determine
become incredibly complex. With improvements in
ways in which surgery could be made safer for patients. The end
knowledge and technology, we have managed to make
result of the meeting was a first draft of a surgical checklist. The
commonplace the treatment of diseases and injuries
checks were arranged at three critical time points: prior to anesthesia,
that were once thought to be untreatable. However, this increase in
prior to surgical incision, and prior to leaving the operating room
complexity can also predispose us to errors in the fast-paced, high-
after the procedure. Ultimately, the final draft of the checklist
stress setting of a hospital, be it human or veterinary.
contained 19 specific checks (see image below).
A Harvard medical records query revealed that in daily practice
From 2007 to 2008, the surgical checklist was implemented in eight
the average physician manages 250 primary diseases and conditions,
hospitals around the world. The results were breathtaking: major
must consider over 900 concurrent active medical problems,
complications dropped by 36%, deaths fell by 47%, infections fell
prescribes 300 different medications, orders 100 individual laboratory
by almost 50%, and the number of patients having to return to the
tests, and performs more than 40 unique procedures.
operating room due to bleeding or technical problems dropped by
The statistics are probably similar in the veterinary world, though
25%. In all, the checklist was used in an estimated 4,000 cases; it was
one must also consider that we treat several different species and a
estimated to have saved 150 people from harm and 27 from death.
constantly growing number of breeds of animal. Physicians in today’s
A decade after the introduction of the surgical checklist, similar lists
world are some of the best and brightest, and are also incredibly
are used in human and veterinary hospitals throughout the country
highly trained—consider that in the early 1900s, one needed just
and the world. And PVSEC is no exception. It’s just one example of our
a high school diploma and a one-year medical degree to become
dedication to keeping your pet safe during his or her hospital stay.
a doctor; today, doctors must have a college degree, a four-year
If you are interested in reading more about the evolution of the surgical
medical school education, and three to seven years of post-doctoral
safety checklist, I highly recommend Dr. Atul Gawande’s “The Checklist
training in a specific area of practice. Nonetheless, medicine has
Manifesto” (Metropolitan Books, 2009).
become so complex that it can be difficult for humans—mere
mortals—to handle.
One way in which the human medical
field has attempted to manage the problem
Surgical Safety Checklist
of increasing complexity is through
specialization, and even sub-specialization.
Before induction of anaesthesia
Before skin incision
Before patient leaves operating room
For example, physicians may focus th