Implementation of Safe Surgery Saves Lives initiative in Ahmed ...

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Chapter 1Introduction1.1 IntroductionThe increasing of healthcare services complexity over the past decade and increasing of coveragehas led to a corresponding rise in the number of reported adverse events, defined as unintendedinjuries caused by medical error rather than the disease process itself (Michel, Quenon, deSarasqueta, & Scemama, 2004). Good documentation and reporting systems also helped inidentifying the size of problem, such as in the famous report of the US Institute of Medicinenamed „„To Err is Human: Building a Safer Health System,‟‟ (IOM, 2000). The huge size ofreported medical errors led to establishment of patient safety initiative, and formation of WorldAlliance for Patient Safety. It was identified as a one of the key tasks facing healthcare at thestart of the 21st century. This Safety concept implementation has succeeded in ensuring safety inaviation industry a long before (Donaldson, L J, 2007). By focusing attention on this as a publichealth issue, World Alliance for Patient Safety was recognized the importance of improving thesafety of surgery as the second global patient safety challenge (WHO, 2008).1.2 Rationale for carrying out the changeMedical errors and incidence of traumatic injuries in surgical care services were recognized as aproportion of the total global burden of disease. Surgical care and procedures can potentiallyaffect the lives of millions of people worldwide. Studies done by WHO found that wrong person,wrong procedure, and wrong site surgery is a preventable adverse event, and defined a core set ofminimum standards that can be applied universally across borders and settings, and developed aSurgical Safety Checklist as a tool to ensure safety culture, teamwork, communications,information handoff, patient involvement, and check of processes. WHO Alliance for PatientSafety promote applying those standards through the ““Safe Surgery Saves Lives”” program8
(WHO, 2008), hopes to create an environment for improving both access to and safety ofsurgical care.Safe Surgery Saves Lives program, aims to improve the safety of surgical care. Nevertheless thesurgery nowadays is advanced, complicated, and widely practiced in almost all healthcarefacilities around the world, and even the advanced invasive procedures such as cardiac surgeryhave been came in practice in developing countries.The final goal of the “Safe Surgery Saves Lives” initiative is to improve surgical outcomes forpatients regardless of circumstance or environment. By improving processes already in place inoperating theatres safety will be enhanced and quality increased without demanding substantialfinancial investments in health infrastructure (WHO, 2008). The WHO Alliance for PatientSafety designed the initiative to be simple, widely applicable, and measurable regardless of theoperative setting to ensure adherence to proven standards of care in all countries. This initiativepiloted in eight countries from different WHO regions, economic circumstances and diversepopulations of patients, (Hayned, et al., 2009). Hospitals in eight cities around the globe havesuccessfully demonstrated that the use of a simple surgical checklist, developed by WHO, duringmajor operations can lower the incidence of surgery-related deaths and complications by onethird. Analysis shows that the rate of major complications following surgery fell from 11% in thebaseline period to 7% after introduction of the checklist, a reduction of one third. Inpatientdeaths following major operations fell by more than 40% (from 1.5% to 0.8%). It provedapplicability, efficiency and effectiveness and It reduced mortality and morbidity in all eightcenters (Figure 1), from the high-performing ones to the developing ones (Hayned, et al., 2009).At least half a million deaths per year would be preventable with worldwide effectiveimplementation of the checklist.9
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Page 8 and 9: AbstractAim: This paper reports on
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