Impact of Surgical Checklist on Mortality, Reoperation, and Readmission Rates in Brazil, a Developing Country, and Canada, a Developed Country.

Purpose: To compare the mortality, reoperation, and readmission rates before and after the implementation of a surgical checklist in Brazil and Canada.

Design: An epidemiological, retrospective study was conducted.

Methods: Preimplementation and postimplementation data were collected via patient chart reviews to determine mortality, reoperation, and readmission rates.

Findings: In Brazil, a decrease in readmission rate from 2.9% to 1.7% (P = .518) was observed after the implementation of the checklist. In Canada, reoperation rate decreased from 5.6% to 4.8% (P = .649) and mortality from 1.7% to 0.9% (P = .407) after implementation. In the Brazilian institution, patients with incomplete checklists had increased rates of readmission, from 1.4% to 2.4% (P = .671), and reoperation, from 6.8% to 10.4% (P = .232).

Conclusions: The use of surgical checklist did not translate into improvements in the outcomes studied after its implementation in any of the scenarios evaluated. This result is possibly justified by the socioeconomic structure of each of these settings.