WASHINGTON — Surgical teams that followed a basic cockpit-style checklist in the operating room, from confirming the patient's name to discussing expected blood loss, reduced the rate of deaths and complications by more than one-third, according to a year-long, eight-nation project being released today.

Surgeons, it seems, are discovering what airline pilots learned decades ago: The human brain can't remember everything, so it's best to focus on the complicated challenges and leave the simple reminders to a cheat sheet.

"You take something as complex as surgery, and you think there isn't a lot that can be done to make it better," said Atul Gawande, a Boston physician who led the study being published in the New England Journal of Medicine. "A checklist seems like a no-brainer, but the size of the benefit is dramatic."

Tested in eight hospitals

The low-cost, low-tech intervention tested in eight hospitals around the globe could have enormous financial implications as well.

If every operating room in the United States adopted the surgical checklist, the nation could save between $15 billion and $25 billion a year in the costs of treating avoidable complications, according to calculations by the authors.

In the one-year pilot study involving 7,600 patients, the hospitals saw the rate of serious complications fall from 11 percent to 7 percent. In-patient deaths declined by more than 40 percent overall, with the most drastic reductions occurring in hospitals with fewer resources.

For the study, which was prompted by the World Health Organization, hospitals in eight countries adopted a 19-step checklist in non-cardiac surgeries. The project involved rural and urban hospitals with diverse populations in cities such as Seattle, London, New Delhi, Manila and Ifakara, Tanzania.

According to the checklist, before an operation begins, the team members introduce themselves, review the patient's name and the procedure to be done. They discuss allergies, confirm that all equipment has been sterilized and necessary antibiotics administered, and assess potential problems such as blood loss. After the surgery, but before the patient leaves the operating room, the team returns to the checklist, labeling specimens and ensuring that all equipment has been removed from the patient.

"Ready right now"

Though the steps are routine, an astonishing number of doctors and nurses miss at least one, Gawande said.

"I cannot recall a clinical-care innovation in the past 30 years that has shown results of the magnitude demonstrated by the surgical checklist," said Donald Berwick, the physician president of the Institute for Healthcare Improvement, which promotes high-quality advances in the delivery of care.

"This is a change ready right now for adoption by every hospital that performs surgery."

Very few U.S. hospitals are using the surgical safety checklist, though Berwick aims to introduce it in the 4,000 hospitals participating in his institute's programs.

The major barrier to widespread adoption is physician attitudes, several experts said.

"If you ask surgeons, they'll say, 'Oh, we do this stuff,' " Gawande said. He himself was skeptical that the checklist would affect the eight to 10 operations he performs each week.

"I don't get through a week where it has not caught something," he said.