Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study
• Checklists avoid human errors and are commonly used in high-reliability industries.• The “InCor Checklist” was associated with decreased mortality over time.• Adherence, completeness, and sustainability within public policies are necessary. To evaluate the impact of adherence to the cardiac surgic...
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| Veröffentlicht in: | Clinics (São Paulo, Brazil) Brazil), 2022-01, Vol.77, p.100048, Article 100048 |
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| creator | Mejia, Omar Asdrúbal Vilca de Mendonça, Frederico Carlos Cordeiro Sampaio, Lucimar Aparecida Barrense Nogueira Galas, Filomena Regina Barbosa Gomes Pontes, Mauricio Franklin Caneo, Luiz Fernando Dallan, Luís Roberto Palma Lisboa, Luiz Augusto Ferreira Ferreira, João Fernando Monteiro Dallan, Luís Alberto de Oliveira Jatene, Fabio Biscegli |
| description | • Checklists avoid human errors and are commonly used in high-reliability industries.• The “InCor Checklist” was associated with decreased mortality over time.• Adherence, completeness, and sustainability within public policies are necessary.
To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital.
A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist “Five steps to safe cardiac surgery” in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson's coefficient was calculated using R software.
Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%).
In the formation of the surgical patient safety culture, the implementation and adherence to the InCor-Checklist “Five steps to safe cardiac surgery” was associated with decreased mortality after cardiac surgery. |
| doi_str_mv | 10.1016/j.clinsp.2022.100048 |
| format | Article |
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To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital.
A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist “Five steps to safe cardiac surgery” in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson's coefficient was calculated using R software.
Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%).
In the formation of the surgical patient safety culture, the implementation and adherence to the InCor-Checklist “Five steps to safe cardiac surgery” was associated with decreased mortality after cardiac surgery.</description><identifier>ISSN: 1807-5932</identifier><identifier>ISSN: 1980-5322</identifier><identifier>EISSN: 1980-5322</identifier><identifier>DOI: 10.1016/j.clinsp.2022.100048</identifier><identifier>PMID: 35594622</identifier><language>eng</language><publisher>United States: Elsevier España, S.L.U</publisher><subject>Cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; Checklist ; Checklists ; Cross-Sectional Studies ; Hospital Mortality ; Hospitals, Teaching ; Humans ; MEDICINE, GENERAL & INTERNAL ; Mortality ; Original ; Quality improvement ; Retrospective Studies</subject><ispartof>Clinics (São Paulo, Brazil), 2022-01, Vol.77, p.100048, Article 100048</ispartof><rights>2022 HCFMUSP</rights><rights>Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.</rights><rights>2022 HCFMUSP. Published by Elsevier España, S.L.U. 2022 HCFMUSP</rights><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c502t-30e533369300c4807159dfcde22d1cd782e35ff68775fdfc3e1e8ac870749a573</citedby><cites>FETCH-LOGICAL-c502t-30e533369300c4807159dfcde22d1cd782e35ff68775fdfc3e1e8ac870749a573</cites><orcidid>0000-0001-6175-5595 ; 0000-0002-8765-8010 ; 0000-0001-6490-8868 ; 0000-0003-0803-403X ; 0000-0001-5545-8172 ; 0000-0001-8137-5434 ; 0000-0002-1635-4984 ; 0000-0001-9184-7140 ; 0000-0002-8655-8966 ; 0000-0002-8899-1763 ; 0000-0002-2137-0604</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123198/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123198/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35594622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mejia, Omar Asdrúbal Vilca</creatorcontrib><creatorcontrib>de Mendonça, Frederico Carlos Cordeiro</creatorcontrib><creatorcontrib>Sampaio, Lucimar Aparecida Barrense Nogueira</creatorcontrib><creatorcontrib>Galas, Filomena Regina Barbosa Gomes</creatorcontrib><creatorcontrib>Pontes, Mauricio Franklin</creatorcontrib><creatorcontrib>Caneo, Luiz Fernando</creatorcontrib><creatorcontrib>Dallan, Luís Roberto Palma</creatorcontrib><creatorcontrib>Lisboa, Luiz Augusto Ferreira</creatorcontrib><creatorcontrib>Ferreira, João Fernando Monteiro</creatorcontrib><creatorcontrib>Dallan, Luís Alberto de Oliveira</creatorcontrib><creatorcontrib>Jatene, Fabio Biscegli</creatorcontrib><title>Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study</title><title>Clinics (São Paulo, Brazil)</title><addtitle>Clinics (Sao Paulo)</addtitle><description>• Checklists avoid human errors and are commonly used in high-reliability industries.• The “InCor Checklist” was associated with decreased mortality over time.• Adherence, completeness, and sustainability within public policies are necessary.
To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital.
A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist “Five steps to safe cardiac surgery” in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson's coefficient was calculated using R software.
Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%).
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To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital.
A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist “Five steps to safe cardiac surgery” in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson's coefficient was calculated using R software.
Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%).
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| identifier | ISSN: 1807-5932 |
| ispartof | Clinics (São Paulo, Brazil), 2022-01, Vol.77, p.100048, Article 100048 |
| issn | 1807-5932 1980-5322 1980-5322 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Cardiac surgery Cardiac Surgical Procedures - adverse effects Checklist Checklists Cross-Sectional Studies Hospital Mortality Hospitals, Teaching Humans MEDICINE, GENERAL & INTERNAL Mortality Original Quality improvement Retrospective Studies |
| title | Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study |
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