Professor Chris Baggoley, Chief Executive, Australian Commission on Safety and Quality in Healthcare, has sent in the following comment re the recent post on whether Australian hospitals should be implementing the WHO surgical safety checklist to reduce deaths and complications associated with surgery:
“The Commission is very keen to work with (and has spoken to) the College of Surgeons and the College of Anaesthetists in the implementation of the WHO Surgical Safety Checklist in Australia.
The Commission notes that Prof Bruce Barraclough of RACS and Dr Alan Merry of ANZCA, both eminent leaders in their respective colleges, were members of the Steering Committee overseeing this important research which was published in the New England Journal of Medicine in January this year.
With the Commission working in harmony with the clinicians, the prospect of a successful widespread implementation of this initiative is significantly enhanced.
I note that the death rate quoted in the paper was 1.5%. No Australian hospital was in the eight that took part worldwide – the closest to us was in Auckland – so I cannot be confident that this reflects the underlying surgical death rate in this country (nor in Auckland). I would be very surprised if it was anywhere near that level.
I do note the advice I have already received that most elements of the checklist are already routine practice in operating theatres in Australia and that countries can tailor these elements, including adding to them, to fit the requirements of their patients.”
PS from MS: Seems like there might be an interesting study sometime down the track – looking at how widely the checklist, or similar, is being used and with what effect. And, if it’s not being used, why not…
So..the confusion continues but the end point of both the recent studies appears to be that so-called PSA ‘screening’ finds more prostate cancers yet in finding those cancers early does little to reduce the risk of dying from the disease. But amongst the numerous comments following publication is the very surprising one from Dr Otis Brawley, the Chief Medical Officer of the American Cancer Society who said of the data from the European study (in the New York Times):”The test is about 50 times more likely to ruin your life than it is to save your life” Now lets not forget that the American Cancer Society has over the years stubbornly supported PSA screening. They have been the only cancer society in the NGO sector in the western world to support the test. Does this mean they have re-considered? Or is Dr Brawley having a problem persuading his professional colleagues that the time has come to think again?