Washington surgeons set new guidelines for patient safety

Washington State surgeons recently announced standardized guidelines for preoperative care in the form of pre-surgical checklists and tools available to all surgeons to use in their offices or by patients at home to ensure that the health of patients is optimized before surgery.

The Strong for Surgery checklists assess whether patients have modifiable risks for surgery and then offer a set of interventions to reduce the risk before hospitalization. They address four target areas: nutritional support to prevent infections, reducing cigarette smoking, reviewing and coordinating potentially dangerous medications, and improving diabetes care before surgery.

Nearly one-third of hospitalized patients experience adverse events related to their care, and far too often these events are preventable. While quality improvement initiatives have made surgery safer and have achieved improved outcomes, they usually focus on the care of patients once they enter the hospital. Strong for Surgery provides the opportunity for early intervention to reduce risks prior to hospitalization.

“Strong for Surgery takes the idea of checklists and moves them to where decisions are being made before the patient gets to the hospital,” says Tom Varghese, MD, who is leading Strong for Surgery. Varghese is an associate professor in the Department of Surgery at the University of Washington and the director of the thoracic surgery program at Harborview Medical Center, both in Seattle. “Putting the checklist in every doctor’s office across the state takes the focus of surgical safety beyond the operating room,” he says. “Surgical preparedness now becomes part of the basic conversation about planning for surgery, and the patient shares in that process. It empowers patients.”

Strong for Surgery is a public health campaign that engages doctors, nurses, other clinical staff and, most importantly, patients and their families to make Strong for Surgery checklisting universal. Free Implementation Guides to assist hospitals, clinics, and doctor’s offices in successfully implementing the Strong for Surgery checklists are available on the website at www.strongforsurgery.org. The Implementation Guide contains all of the Strong for Surgery checklists and all of the accompanying resources, references, forms, and other supporting materials. (Click on “Clinicians, Learn More About Optimizing Health Prior to Surgery,” then on the left side of the page, select “Request the Implementation Guide.”) There is a specific section on the website for patients, so that individuals may download the checklists and bring them to their doctor’s office to ensure that any areas of concern are reviewed and addressed.