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Spine surgeries: Effective checklist reduces adverse events by 30 percent

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Dr Arvind Kulkarni
Pertaining to the fact that a simple checklist before a surgical intervention has the potential to reduce human errors and medical negligence thereby preventing morbidity and mortality, WHO has recently accepted the importance of a checklist and stated that it can reduce the cases of death by at least 30%.
This came after WHO found in research that maintaining a proper checklist reduced at least 30% of the complications and deaths. The team led by Dr Arvind Kulkarni, prepared a 37 points checklist that reduced preventable errors in peri-operative care from 14.24% to 3.50%. His paper was published in the latest edition of the Asian Spine Journal’ and bagged awards in ‘Safety in Spine Surgery Project.
Dr Arvind Kulkarni, Head – Mumbai Spine Scoliosis and Disc Replacement Centre/ Bombay Hospital, and his team was recently awarded with an international award for coming up with an elaborate checklist for spine surgeries. Dr Arvind Kulkarni bags international award for publishing 37-point checklist to ensure safety during spine surgeries
He stated that checklists in recent times have become extremely important, and that too in complicated spinal surgeries where even a few millimeters could make a huge difference. Such small preventive measures could reduce simple human errors, save lives, money and time. Since spinal surgeries are highly demanding, with hundreds of real time decisions to make, right from checking the type and length of the screw, till the type of approach to be followed.
A study done in 2016 by University of London that was published in the ‘British Journal of Anaesthesia’ said 50 million patients suffered complications after surgery each year and 1.5 million people die following complications. Infection of surgical wounds is found to be the most frequent complication.
Dr Kulkarni further added that surgical errors due to the presence of untrained staff (OT boys and nurses), high volume of surgeries, limited resources and lack of inventory etc. A checklist doesn’t teach you how to perform the surgery, it facilitates effective communication between team members and ensures that small errors (such as leaving mop behind) don’t occur. It is to reduce these numbers that checklists have become common in medical corridors.
(The author is Head – Mumbai Spine Scoliosis and Disc Replacement Centre/ Bombay Hospital)


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