Lifesaving list

WHENEVER surgeons put a scalpel to flesh, enough complications to fill several episodes of "House" or "General Hospital" can occur. Anesthesia can go awry, infections can be transmitted, surgeons can operate on the wrong side, sponges can be left in the patient. To limit the frequency of these problems, reformers have advocated that surgical teams use verbal safety checklists, in which doctors and nurses must affirm out loud that they have taken certain safety steps over the course of an operation.

Recently, a study in the New England Journal of Medicine showed just how effective such simple methods can be in avoiding complications, whether infection, the need for a second operation, or death. The checklists should be tried out more broadly.

In the international study conducted at eight hospitals, the checklists reduced complications significantly - from 11 percent to 7 percent after the teams began using the checklists. The frequency of deaths fell from 1.5 percent of patients to 0.8 percent, a drop of more than a third. The teams ran through the checks before the patient was given anesthesia, before the first incision, and before the patient left the operating room.

According to Dr. Atul Gawande, one of the authors of the study and a surgeon at Brigham and Women's Hospital, cardiac and general surgeons at the Brigham began using the checklist a month ago. Getting more healthcare professionals to adopt the practice is no easy matter. But the few minutes required for the checks are worth it if they can head off costly complications.

The Cambridge-based Institute for Healthcare Improvement wants 4,000 hospitals to adopt the checklist in at least one operating room in the next three months. That should produce even more evidence that a check in time saves nine.