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dc.contributor.authorHaugen, Arvid Steinaren_US
dc.contributor.authorSøfteland, Eiriken_US
dc.contributor.authorAlmeland, Stian Krekenen_US
dc.contributor.authorSevdalis, Nicken_US
dc.contributor.authorVonen, Bartholden_US
dc.contributor.authorEide, Geir Egilen_US
dc.contributor.authorNortvedt, Monica Wammenen_US
dc.contributor.authorHarthug, Stigen_US
dc.date.accessioned2014-09-17T12:09:47Z
dc.date.available2014-09-17T12:09:47Z
dc.date.issued2015-05eng
dc.identifier.issn0003-4932
dc.identifier.urihttps://hdl.handle.net/1956/8501
dc.description.abstractObjectives: We hypothesized reduction of 30 days’ in-hospital morbidity, mortality, and length of stay postimplementation of the World Health Organization’s Surgical Safety Checklist (SSC). Background: Reductions of morbidity and mortality have been reported after SSC implementation in pre-/postdesigned studies without controls. Here, we report a randomized controlled trial of the SSC. Methods: A stepped wedge cluster randomized controlled trial was conducted in 2 hospitals. We examined effects on in-hospital complications registered by International Classification of Diseases, Tenth Revision codes, length of stay, and mortality. The SSC intervention was sequentially rolled out in a random order until all 5 clusters—cardiothoracic, neurosurgery, orthopedic, general, and urologic surgery had received the Checklist. Data were prospectively recorded in control and intervention stages during a 10-month period in 2009– 2010. Results: A total of 2212 control procedures were compared with 2263 SCC procedures. The complication rates decreased from 19.9% to 11.5% (P < 0.001), with absolute risk reduction 8.4 (95% confidence interval, 6.3–10.5) from the control to the SSC stages. Adjusted for possible confounding factors, the SSC effect on complications remained significant with odds ratio 1.95 (95% confidence interval, 1.59–2.40). Mean length of stay decreased by 0.8 days with SCC utilization (95% confidence interval, 0.11–1.43). In-hospital mortality decreased significantly from 1.9% to 0.2% in 1 of the 2 hospitals post-SSC implementation, but the overall reduction (1.6%–1.0%) across hospitals was not significant. Conclusions: Implementation of the WHO SSC was associated with robust reduction in morbidity and length of in-hospital stay and some reduction in mortality.en_US
dc.language.isoengeng
dc.publisherLippincott, Williams & Wilkinseng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/8502" target="blank">Impact of a surgical safety checklist on safety culture, morbidity, and mortality. A stepped-wedge cluster randomised controlled trial</a>eng
dc.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/eng
dc.subjectChecklisteng
dc.subjectMorbidityeng
dc.subjectMortalityeng
dc.subjectRandomized controlled trialeng
dc.subjectSurgeryeng
dc.titleEffect of the World Health Organization Checklist on Patient Outcomes: A Stepped Wedge Cluster Randomized Controlled Trialen_US
dc.typePeer reviewed
dc.typeJournal article
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2014 by Lippincott Williams & Wilkins
dc.identifier.doihttps://doi.org/10.1097/sla.0000000000000716
dc.identifier.cristin1133032
dc.source.journalAnnals of Surgery
dc.source.40261
dc.source.145
dc.source.pagenumber821-828


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