Journal of Gastrointestinal Surgery

, Volume 19, Issue 5, pp 935–942 | Cite as

Implementation of a Surgical Safety Checklist and Postoperative Outcomes: a Prospective Randomized Controlled Study

  • Neeraj ChaudharyEmail author
  • Vibha Varma
  • Sorabh Kapoor
  • Naimish Mehta
  • Vinay Kumaran
  • Samiran Nundy
Original Article


The implementation of a surgical safety checklist is said to minimize postoperative surgical complications. However, to our knowledge, no randomized controlled study has been done on the influence of checklists on postoperative outcomes in a developing country. We conducted a prospective randomized controlled study with parallel group study design of the implementation of WHO surgical safety checklist involving 700 consecutive patients undergoing operations in our hospital between February 2012 and April 2013. In 350 patients, the checklist was implemented with modifications—the Rc arm. The control group of 350 patients was termed the Rn arm. The checklist was filled in by a surgery resident, and only the participants in the study were blinded. Postoperative wound-related (p = 0.04), abdominal (p = 0.01), and bleeding (p = 0.03) complications were significantly lower in the Rc compared to the Rn group. The number of overall and higher-grade complications (Clavien-Dindo grades 3 and 4) per patient reduced from 0.97 and 0.33 in the Rn arm to 0.80 and 0.23 in the Rc arm, respectively. A significant reduction in mortality was noted in the Rc arm as compared to the Rn arm (p = 0.04). In a subgroup analysis, the number of overall and higher-grade complications per patient with incomplete checklists was higher than that with fully completed checklist group. Implementation of WHO surgical safety checklist results in a reduction in mortality as well as improved postoperative outcomes in a tertiary care hospital in a developing country.


Surgical checklist Randomized study Postoperative outcomes 





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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Neeraj Chaudhary
    • 1
    Email author
  • Vibha Varma
    • 1
  • Sorabh Kapoor
    • 1
  • Naimish Mehta
    • 1
  • Vinay Kumaran
    • 1
  • Samiran Nundy
    • 1
  1. 1.Department of Surgical Gastroenterology and Liver TransplantationSir Ganga Ram HospitalNew DelhiIndia

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