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Background to Safe Surgery Saves Lives

Why safe surgery is important

Surgical care has been an essential component of health care worldwide for over a century. As the incidences of traumatic injuries, cancers and cardiovascular disease continue to rise, the impact of surgical intervention on public health systems will grow.

Surgery is often the only therapy that can alleviate disabilities and reduce the risk for death from common conditions. Each year many millions of people undergo surgical treatment due to traumatic injuries, pregnancy-related complications, and to treat malignancies.

While surgical procedures are intended to save lives, unsafe surgical care can cause substantial harm. Given the ubiquity of surgery, this has significant implications for public health. Mortality from general anaesthesia alone is reported to be as high as one in 150 in parts of sub-Saharan Africa. Infections and other postoperative morbidities are also a serious concern around the world.

What the World Health Organization is doing

WHO has undertaken a number of global and regional initiatives to address surgical safety. The Global Initiative for Emergency and Essential Surgical Care and the Guidelines for Essential Trauma Care focussed on access and quality. The Second Global Patient Safety Challenge: Safe Surgery Saves Lives addresses the safety of surgical care. WHO Patient Safety initiated work on the Challenge in January 2007.

The goal of the Challenge is to improve the safety of surgical care around the world by defining a core set of safety standards that can be applied in all WHO Member States. To this end, working groups of international experts were convened to review the literature and the experiences of clinicians around the world. They reached consensus on four areas in which dramatic improvements could be made in the safety of surgical care: surgical site infection prevention, safe anaesthesia, safe surgical teams and measurement of surgical services.

The Second Global Patient Safety Challenge aims to foster improved surgical safety and to reduce deaths and complications during surgery in four ways:

• by providing information on the role and patterns of surgical safety in public health to clinicians, hospital administrators and public health officials;
• by defining a minimum set of uniform measures, or ‘surgical vital statistics’, for national and international surveillance of surgical care;
• by identifying a simple set of surgical safety standards that are applicable in all countries and settings and are compiled in a checklist for use in operating rooms; and
• by evaluating and disseminating the checklist and surveillance measures at pilot sites in every WHO region, initially, and then to hospitals worldwide.