Are We A Safe Surgery 2015: South Carolina Checklist Hospital?

Many hospitals have been working on putting a modified version of the WHO Surgical Safety Checklist into their operating rooms for years. A majority of these facilities feel that they have achieved a full and effective implementation process. However, when we talk to them and observe how they are using the checklist many have achieved great success with putting the processes on the checklist into place, but have missed the critical piece of engaging surgeons directly. In order for the checklist to be effective it must be used as a communication tool to enhance teamwork in the OR and not merely as a tool to document processes completed by the nursing staff alone.

If you think that your hospital optimally uses the checklist and has achieved an effective and full implementation we encourage you to return to your hospital and complete the steps that we have outlined below:

  1. Go back to your hospital and find out how the checklist work is going. Provide your checklist implementation team and leaders with this document to assess where you are in terms of checklist use.
  2. Give the attached form to random anesthesiologists, circulating nurses, CRNA’s, OR managers, residents, PAs, perfusionists, scrub techs, and surgeons and other operating room personnel. Ideally at least one person from each discipline should complete this form. If everybody that completes the form answers “yes” to every question you are on your way to becoming a Safe Surgery 2015: South Carolina Checklist Hospital.
  3. For more information about this initiative, please visit our website, If you would like to talk to a member of the Safe Surgery 2015 team please connect with us at .

Are we getting the most out of the checklist? (Are we done?)

Yes / No
1. / Does your surgical checklist have three phases, before induction of anesthesia, before skin incision, and before the patient leaves the room? /  / 
2. / Are the items on the checklist read aloud, without reliance on memory, so all members of the team can hear them? /  / 
3. / Are all three phases of the checklist performed for every patient undergoing a surgical procedure in your hospital’s operating rooms? /  / 
4. / Does every person that is present in the operating room say something before skin incision, at a minimum they introduce themselves by name and role or state that they are ready to proceed? (This includes perfusionists, surgical assistants, PAs, residents, observers, manufacturer representatives, and other observers) /  / 
5. / Does the surgeon share an operative plan and discuss: anticipated blood loss, expected duration of the procedure, possible difficulties, and implants or special equipment needed for the case with theentire team before skin incision? /  / 
6. / Do nurses and surgical techs discuss with the entire teamtheir concerns about the patient? /  / 
7. / Do the anesthesia providers discuss with the entire team the anesthetic plan and airway or other concerns? /  / 
8. / Does the surgeon ask the entire team to speak up if they have any concerns during the case? /  / 
9. / Before the patient leaves the OR do ALL members of the surgical team discuss equipment problems that need to be addressed, key concerns for recovery and management, and anything that could have been done better to make the case safer or more efficient? /  / 