Improving the WHO Surgical Safety Checklist sign-out.

Area of Science:

• Surgery
• Patient Safety
• Quality Improvement

Background:

• The World Health Organization (WHO) Surgical Safety Checklist is crucial for reducing perioperative morbidity and mortality.
• The sign-out phase is often poorly executed due to high team workload.
• This study investigated optimizing the sign-out process for better adherence.

Purpose of the Study:

• To evaluate the impact of a modified surgical checklist sign-out on compliance.
• To determine the optimal timing for the sign-out process.
• To assess team member participation and checklist completion rates.

Main Methods:

• A controlled longitudinal study comparing before-and-after intervention in a surgical department.
• Workload assessment to identify optimal sign-out timing.
• Iterative, multidisciplinary modification of the sign-out process based on workload data and staff feedback.

Main Results:

• The optimal sign-out timing was identified as after final wound closure.
• The modified process significantly improved active team member participation (P=0.010).
• While complete compliance improved in the control group, active participation decreased.

Conclusions:

• The optimal timing for surgical checklist sign-out is immediately after final wound closure, before patient undraping.
• Modifications to the sign-out process can enhance team engagement and adherence to safety protocols.
• The majority of staff surveyed viewed the modifications positively.