Related Experiment Video
Updated: Jul 4, 2026
Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Reimagining the surgical safety checklist through a pediatric lens
Robin Wigen1, Kaitlyn Squires2, Mercedes Pilkington3
1Alberta Children's Hospital, Pediatric General Surgery, Calgary, Alberta, Canada.
Insights
Pediatric surgeons seek to optimize the Surgical Safety Checklist (SSC) for better communication and to prevent wrong-site surgery. Enhancements include pediatric-specific elements and improved implementation strategies for enhanced patient safety.
Area of Science:
- Pediatric Surgery
- Patient Safety
- Quality Improvement
Background:
- The Surgical Safety Checklist (SSC) is a critical tool in perioperative care.
- Optimizing the SSC for the unique needs of pediatric patients is essential.
Purpose of the Study:
- To gather perspectives from North American pediatric surgeons on optimizing the SSC.
- To enhance the SSC for the contemporary pediatric perioperative population.
Main Methods:
- Mixed-methods study involving a North American survey of pediatric surgeons.
- Structured convening with focus groups and large-group discussions.
- Deductive thematic analysis of facilitated conversations.
Main Results:
- Survey respondents prioritized preventing wrong surgery and improving team communication.
- Participants suggested removing redundant items and adding pediatric-specific elements (e.g., patient weight, hypothermia risk).
- Implementation strategies included morning huddles, defined parent roles, and digitized checklist design.
Conclusions:
- Opportunities exist to enhance perioperative safety through pediatric SSC reimplementation.
- Re-engaging pediatric surgical teams is crucial for improving patient outcomes.
Purpose:
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.
Methods:
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.
Results:
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.
Conclusion:
These findings identify opportunities to enhance perioperative safety and re-engage pediatric surgical teams through pediatric SSC reimplementation.