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An evaluation into the effectiveness of surgical safety checklists in veterinary procedures

02 June 2021
11 mins read
Volume 12 · Issue 5



Extensive research has been conducted evaluating surgical safety checklists in human medicine, but comparative research is lacking within veterinary medicine.


To evaluate the possible benefits of applying a surgical safety checklist to veterinary procedures.


The checklist, created by the Association of Veterinary Anaesthetists (AVA), was applied to roughly 50% of patients undergoing surgical procedures in a veterinary practice in Edinburgh, Scotland during an 8-week period in 2020. The remaining 50% was not subjected to a checklist and was therefore used as a control group.


With the application of the checklist, the practices participating in the study experienced a 4% decrease in postoperative complications, although this was not statistically significant.


The frequency of postoperative complications after surgical procedures reduced following the introduction of surgical safety checklists.

In 2008 the World Health Organization (WHO) introduced a surgical safety checklist as a part of the Safe Surgery Saves Lives campaign (Weiser and Haynes, 2018). Now, over a decade later, recordings from eight major hospitals around the world (Canada, India, Jordan, New Zealand, The Philippines, Tanzania, UK and USA) show a decrease in mortality and complications of 37–48% after implementing the checklist (Tang et al, 2014).

There is a rising trend within the veterinary profession to perform increasingly complicated and invasive surgery on family pets through the use of more intricate techniques trickling down from human medicine (McMillan, 2014). With these surgeries comes the increasing risk of postoperative complications (McMillan, 2014).

In human medicine, it is estimated that 7 million people will experience surgical complications each year and out of that group, 1 million people succumb to fatal complications (World Health Organization (WHO), 2014). It is thought that half of these deaths could be prevented (WHO, 2014). In 1991, Harvard medical practice first raised an issue with patient safety, showing that 3.7% of patients suffered medical harm or complications while hospitalised (Tivers, 2015). Furthermore, human error is responsible for up to 70% of anaesthesia-related deaths in humans (Hofmeister, et al, 2014). As a result of this, the World Health Organization decided to take inspiration from the use of safety checklists in aviation and other high-reliability industries (Clay-Williams and Colligan, 2015). The flight checklist is used to enforce communication between crew members, and therefore enable mutual supervision and provide a standard operating procedure to minimise complications (Degani and Weiner, 1993). Medical checklists are used as a cognitive aid to free up mental capacity of the practitioners and allow for visual reminders (Ballantyne, 2018). They are also believed to spread responsibility and reduce the emotional distress for clinicians following potential medical mistakes (Oxtoby and Mossop, 2016). In 2008, the checklist was presented by the WHO as a part of the Safe Surgery Saves Lives campaign. It is now used in all National Health Service (NHS) hospitals throughout the UK (Bradbrook, 2018).

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