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

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.

The two research platforms "Ovid Medline" and "PubMed" formed a solid basis for the literature research. The search was conducted until the 19^th 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.

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.

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.