Impact of the WHO Surgical Safety Checklist Relative to Its Design and Intended Use: A Systematic Review and...

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Surgical Process Optimization

Background:

• The World Health Organization Surgical Safety Checklist (WHO SSC) is a widely adopted tool aimed at improving surgical patient safety.
• Its effectiveness and impact on various aspects of surgical care require ongoing evaluation.
• Understanding which components are most effective and how the checklist aligns with its intended purpose is crucial.

Purpose of the Study:

• To evaluate the effectiveness of the WHO SSC in relation to its design and intended use.
• To identify which parts of the WHO SSC are functioning effectively.
• To explore potential improvements for enhancing the checklist's impact.

Main Methods:

• A qualitative thematic analysis was performed on findings from systematic reviews of the WHO SSC.
• Meta-meta-analyses were conducted on data from included systematic reviews, adhering to PRISMA guidelines.
• Twenty systematic reviews, encompassing 24 observational cohort studies, were analyzed.

Main Results:

• The WHO SSC demonstrated positive impacts on clinical outcomes directly related to its design, including reduced mortality, morbidity, and surgical site infections.
• Themes analyzed included Clinical Outcomes, Process Measures, Team Dynamics, Communication, and Safety Culture, all aligning with the checklist's aims.
• Outcomes such as deep vein thrombosis did not show a statistically significant positive association with WHO SSC use.

Conclusions:

• The WHO SSC positively influences the specific clinical outcomes and safety measures it was explicitly designed to address.
• The checklist's impact is concentrated on its intended areas, with no significant positive effect on aspects outside its original scope.
• The findings support the targeted effectiveness of the WHO SSC in improving surgical safety and patient outcomes.