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Tools/Toolkit > Multi-use Website
Geneva, Switzerland: WHO World Alliance for Patient Safety; June 25, 2008.
This initiative provides a surgical safety checklist and related educational and training materials to encourage international adoption of a core set of safety standards. Implementation of this World Health Organization's checklist has resulted in dramatic reductions in surgical mortality and complications across diverse international hospitals. Surgical checklists have now become one of the clearest success stories in the patient safety movement, although some have described challenges to effective implementation. Dr. Atul Gawande discussed the history of checklists as a quality and safety tool in his book, The Checklist Manifesto: How to Get Things Right.
Journal Article > Study
Avoidability of hospital deaths and association with hospital-wide mortality ratios: retrospective case record review and regression analysis.
Hogan H, Zipfel R, Neuburger J, Hutchings A, Darzi A, Black N. BMJ. 2015;351:h3239.
Challenges in measuring hospital quality persist despite multiple public efforts. A commonly used measure of hospital quality is all-cause mortality. In this study, researchers examined whether two measures of the standardized mortality ratio, which represent differences from expected mortality, are associated with avoidable deaths, defined as those deaths linked to errors. Adjudicators found that less than 5% of deaths were avoidable, and that this proportion was not associated with hospitals' standardized mortality ratios. The authors conclude that the standardized mortality ratio is unlikely to reflect hospital quality, and argue for using condition-specific indicators focused on severe conditions with well-established care pathways. A previous AHRQ WebM&M interview explored the development of hospital standardized mortality ratios and their role in monitoring safety and quality.