Deaths following surgery in Scotland have decreased by 36% since 2008 and the introduction of a patient-focused checklist, according to a study published in the British Journal of Surgery.

The World Health Organization’s (WHO) surgical safety checklist, introduced to hospitals in Scotland as part of the Scottish patient safety programme in 2008, has been credited with contributing to reduced mortality.

Researchers analysed 6.8 million operations that took place between 2000 and 2014 for the study, with rates of mortality falling from 0.76 to 0.46 deaths per 100 procedures over this period. The fall in death rates was seen only in patients who had surgery.

Scotland’s national clinical director, Professor Jason Leitch, said:

“This is a significant study which highlights the reduction in surgical mortality over the last decade. While there are a number of factors that have contributed to this, it is clear from the research that the introduction of the WHO Surgical Safety Checklist in 2008 has played a key role.”

The 19-item checklist is designed to ‘promote a culture of teamwork and communication in operating theatres, helping to improve surgical care and safety’.

“This decline in mortality has been achieved through the hard work of hundreds of people involved in the project across the NHS in Scotland, delivered under the Scottish Patient Safety Programme alongside a number of other surgical safety measures,” Professor Leitch added.

“Behind every one of these statistics is a life saved, demonstrating the impact that the Scottish Patient Safety Programme has had and continues to have on delivering safe, effective and person-centred healthcare for patients. I am delighted that this work, which has the support of Scotland’s Royal Colleges and surgical societies, has been recognised in this way.”

During the years considered by the study, there were over 12.6 million hospital admissions in Scotland, of which over 6.8 million underwent a surgical procedure.

Dr Manoj Kumar, NHS Grampian surgeon and national clinical lead for the Scottish mortality & morbidity review programme, commented:

“This study reaffirms the importance of the WHO Surgical Safety Checklist which functions as a key aide in promoting effective team-working, communication and other relevant non-technical skills in surgery which is critical in ensuring good outcomes.”

Dr Atul Gawande, professor at the Harvard School of Public Health and founder of Ariadne Labs, is a co-author of the study and led the introduction of the WHO Surgical Safety Checklist a decade ago. Responding to the study, he said “Scotland’s health system is to be congratulated for a multi-year effort that has produced some of the largest population-wide reductions in surgical deaths ever documented.”