Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct 31;15(10):5723-5735.
doi: 10.21037/jtd-22-1807. Epub 2023 Sep 15.

Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist-a narrative review

Muriel Wyss  1 , Michaela Kolbe  2   3 , Bastian Grande  1   2   3
Affiliations
Review

Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist-a narrative review

Muriel Wyss et al. J Thorac Dis. .

Abstract

Background and objective: The positive effects of the WHO Surgery Safety Checklist (WHO SSC) have been demonstrated by a large amount of quantitative studies. With this review, the focus changes to the content of qualitative studies on WHO SSC to identify possible research gaps. In this way, gaps in the content of the execution of individual checklists can be closed.

Methods: The two research platforms "Ovid Medline" and "PubMed" formed a solid basis for the literature research. The search was conducted until the 19th of September 2022. The following group terms were used: "checklist", "surgery", "implementation", and "WHO Surgical Safety Checklist". Subsequently, the literature research was limited to studies between 2011 and 2021 in either English or German.

Key content and findings: Overall, a positive effect was found in all qualitative studies on WHO SSC with respect to leadership, teamwork, timing and acceptance. Acceptance through effective implementation of the SSC deserves special mention. Several studies highlighted the lack of understanding and training, which led to variation in execution. A large number of studies agree that the WHO SSC is fostering teamwork and improving communication. However, there are also hurdles and barriers in the application that seem to have an influence on the effectiveness.

Conclusions: The exact mechanisms of the advantage and application of the checklist are still poorly understood. Further research in this area is needed for a better understanding of the underlying work culture and consequently improving patient safety.

Keywords: Checklist; implementation; quality.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-1807/coif). BG serves as an unpaid editorial board member of Journal of Thoracic Disease from February 2022 to January 2024. The other authors have no conflicts of interest to declare.

References

    1. World Health Organization. WHO Guidelines Approved by the Guidelines Review Committee. WHO Guidelines for Safe Surgery 2009: Safe Surgery Saves Lives. Geneva: World Health Organization Copyright © 2009, World Health Organization; 2009.
    1. Armstrong BA, Dutescu IA, Nemoy L, et al. Effect of the surgical safety checklist on provider and patient outcomes: a systematic review. BMJ Qual Saf 2022;31:463-78. 10.1136/bmjqs-2021-014361 - DOI - PubMed
    1. Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360:491-9. 10.1056/NEJMsa0810119 - DOI - PubMed
    1. Weiser TG, Haynes AB, Dziekan G, et al. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010;251:976-80. 10.1097/SLA.0b013e3181d970e3 - DOI - PubMed
    1. Bliss LA, Ross-Richardson CB, Sanzari LJ, et al. Thirty-day outcomes support implementation of a surgical safety checklist. J Am Coll Surg 2012;215:766-76. 10.1016/j.jamcollsurg.2012.07.015 - DOI - PubMed