Safe Surgery Saves Lives William R. Berry, MD, MPH, FACS Cambridge, MA August 2008

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

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 $ US)2,190 50,126,749 (21.8%)35.0% Middle Expenditure Countries (per capita total expenditure on health $ US)4,169 34,636,447 (15.0%)14.6% High Expenditure Countries (per capita total expenditure on health >$1000 US)11, ,090,970 (60.0%)15.6% Total Global Volume of Surgery 230,112,673 Average Surgical Rate3,987

1999 Utah/Colorado study Review of charts from 15,000 admissions to 28 hospitals in 1992 Surgery 1999;126(1):66-75

Safer Surgery Saves Lives First Consultation Geneva Switzerland: 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”

How the Pilot's Checklist Came About

The Surgical Checklist Simple Universal Easily understood Saving lives and decreasing complications

SiteCasesUse of Pulse Oximeter Time Out to Confirm Site/Pt 0-60 mins IV Access >500 cc EBL % 98%93% %8.8%52%73% %100%34%7% %22%25%49% %50%75%80% % 48%32% %99%78%67% %17%18%73% Preliminary Pilot Site Results Total Cases 3234

SiteInfectionComplicationDeath 11.1%7.2%0.4% 21.3%5.3%0% 323.8%24.2%1.7% 43.7%9.8%3.5% 56.5%14%0% 69.4%12%2.1% 73.1%6.4%1.0% 84.0%6.3%1.3% Preliminary Pilot Site Results Total Cases 3234

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