Evidence map›Paper›PMID 41592861›Full record

ArticleBMJ open quality2026

Phased implementation of surgical safety care bundle in a multispecialty, tertiary care teaching hospital: a quality improvement project.

Anita Shirley Joselyn, Lallu Joseph, Anitha Loganathan, Joel Ebenezer, Sonia Abraham, Mark Ranjan

Abstract read
In one paragraph

Article in BMJ open quality, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anita Shirley JoselynAnaesthesia, Christian Medical College and Hospital Vellore, Vellore, India anjeyanth@gmail.com.ORCID 0000-0001-5713-303X
Lallu JosephQuality Management Cell, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Anitha LoganathanQuality Management Cell, Christian Medical College and Hospital Vellore, Vellore, India.
Joel EbenezerQuality Management Cell, Christian Medical College and Hospital Vellore, Vellore, India.
Sonia AbrahamNursing Services, Christian Medical College and Hospital Vellore, Vellore, India.
Mark RanjanGeneral Surgery, Christian Medical College and Hospital Vellore, Vellore, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background'Safe surgery saves lives' initiative by the WHO consists of measures focussed on improving surgical safety. Healthcare institutions across the globe are encouraged to identify the lacunae in surgical safety and adopt these initiatives to suit the local practices and traditions.

methodsA few never events and near misses prompted our institution to create a surgical care safety bundle to improve perioperative patient safety. The surgical care bundle focused on improving the usage of surgical safety checklist (SSCL), surgical consents, surgical site marking (SSM) and sponge count in a phased manner. Baseline audits were conducted for each of the above components at different time points and measures were introduced to improve compliance.

resultsThe baseline usage of SSCL in 2010 was 65% that improved to 70% in 2014, 86% in 2016 and 97% in 2019. The availability of general surgical consents improved from 56% in 2010 to 70% in 2015. With the introduction of specialised surgical consents in 2019, the compliance improved significantly to 99%. SSM was added to the project in 2017, improved from baseline 74% to 95% in 2019 and continues to remain above 90%. Sponge count documentation has been below 80% in 2010 and was implemented as a part of the safe surgery protocol in 2019 after which compliance significantly improved and stayed above 90%. Good compliance with the usage of checklists and improved the safety culture was demonstrated by increased reporting of near miss events. Never events have not occurred after introduction of all components of surgical safety in 2019.

conclusionPhased implementation of surgical care safety bundles, audits and reaudits, repeated educational measures and a slow yet steady process of interventions has markedly improved the safety culture and surgical safety in a larger teaching hospital of a developing country.

Indexed as

Patient Care BundlesPatient SafetyChecklistHospitals, TeachingHumansQuality ImprovementTertiary Care CentersAnaesthesiaCommunicationNever eventsPatient safety

Identifiers

PMID41592861
PMCPMC12853427

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.