October 11, 2021

Impact of WHO Surgical Safety Checklist relative to its design, intended use

By: Judy Mathias
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Editor's Note

This study led by researchers at the NASA Ames Research Center, Moffett Field, California, finds that the World Health Organization (WHO) Surgical Safety Checklist is positively impacting the things it was explicitly designed to address. The analysis included 36 articles and 20 systematic reviews.

A thematic analysis revealed four themes in which the overall impact of the Checklist was positive:


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  • clinical outcomes
  • process measures
  • team dynamics and communication
  • safety culture.

These four themes are directly related to the original aims of the Checklist. Meta-analyses also directly supported these findings and the primary goal of the Checklist to decrease surgical complications.

In addition, the thematic analysis revealed another theme—efficiency and workload—in which the impact was negative. For example, Checklist users believed it slowed down processes in the OR, which indicates that the content of the Checklist may need to be reconsidered in circumstances, such as emergency surgical procedures.

The researchers concluded that although largely positive, there was some variability in impact, and the content of the WHO Surgical Safety Checklist may need to be revisited to determine if there is a need for changes to ensure compliance and its use as intended.

See “Humble giants of leadership: Communication, teamwork, trust: Top tools for leaders,” which describes the development of the WHO Surgical  Safety Checklist by Atul Gawande, MD, MPH, in the June issue of OR Manager. ( https://www.ormanager.com/humble-giants-leadership-2/ )

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