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In 2009, the World Health Organization (WHO) introduced a 19-point surgical safety checklist that significantly lowered the rate of inpatient complications and mortality for patients who underwent noncardiac surgery (NEJM JW Gen Med Feb 3 2009). Despite the checklist's widespread adoption, the effect of mandatory implementation on surgical safety is unclear.
Using administrative data, researchers compared the effects of a surgical checklist at 101 hospitals in Ontario, Canada. After studying 3-month periods before and after implementation of the checklist (>100,000 procedures performed in each period), researchers found no differences in risk-adjusted mortality during hospitalization or within 30 days after surgery (pre-checklist, 0.71%; pos…