Reimagining the surgical safety checklist through a pediatric lens

This study, endorsed by CAPS and APSA leadership, aimed to gather perspectives from North American pediatric surgeons on how the Surgical Safety Checklist (SSC) can be optimized for the contemporary pediatric perioperative population.

This mixed-methods study included a North American survey of pediatric surgeons engaged in quality and safety, followed by a structured convening with focus groups and large-group discussion. Facilitated conversations underwent deductive thematic analysis. Using a sequential explanatory approach, we explored user perspectives on how a pediatric SSC could be optimized in its content, format, and implementation.

Sixty-eight surgeons responded to the survey and 30 participated in the convening, representing 7 provinces and 15 states. Survey respondents emphasized the role of the SSC as a communication tool to improve patient safety. The highest-ranked priorities for a redeveloped SSC were preventing wrong surgery (96%) and improving team communication (93%). Free-text responses identified additional opportunities for SSC refinement. Convening participants suggested the removal of redundant items (e.g., sterility confirmation), addition of pediatric-specific elements, such as patient weight and hypothermia risk, and procedure-based modifiability. Implementation strategies included incorporating a morning team huddle, addressing family needs through defined parent roles, and strengthening safety culture through meaningful audits and improved checklist design, including digitization. Participants also emphasized the importance of adapting SSCs to site-specific contexts.

These findings identify opportunities to enhance perioperative safety and re-engage pediatric surgical teams through pediatric SSC reimplementation.