Safe Surgery NZ programme evaluation – final report

The Commission contracted Sapere Research Group to undertake an evaluation of the first two years of the Safe Surgery NZ programme. The evaluation examines whether Safe Surgery NZ has realised its intended benefits, provided value-for-money and how the programme aligns with the Commission’s strategic priorities.

Key findings

• All DHBs in New Zealand have now implemented the paperless surgical safety checklist, two-thirds have implemented briefings and just over a quarter are undertaking debriefings
  
  
• Levels of engagement with the checklist are improving, with an increased proportion of audits rated at five or above (high engagement)
  
  
• Implementation of briefings and debriefings is still variable across the DHBs, but all DHBs are planning to implement if they have not already done so. Briefings have been cited as one of the most beneficial surgical safety interventions, setting the tone and culture for the day.
  
  
• Debriefings have not been a high priority for implementation, but those who do use it find it useful. At this stage not all DHBs are planning to implement debriefings, and others are intending to leave it up to individual surgeons to adopt. 
  
  
• The evidence on whether the use of the checklist is resulting in safety benefits for patients is incomplete and somewhat mixed. There have been fewer deep vein thrombosis / pulmonary embolism cases than expected since mid-2014, however an increase in sepsis rates requires further investigation.
  
  
• The cost-benefit analysis indicates that if successfully implemented the programme is likely to have a material net benefit to the sector. 
  
  
• At this critical juncture of the programme there is still some work to be done to ensure consistent application of the interventions across all sites for all specialities.
  
  
• There are opportunities to further support the uptake of the interventions through DHB surgical teams and associated specialities such as interventional cardiology and radiology, as well as in private facilities.