Compliance with the WHO Surgical Safety Checklist: A Case Study from Birmingham Children's Hospital

The WHO checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work: before the induction of anaesthesia (“sign in”), before the incision of the skin (“time... [ view full abstract ]

The WHO checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work: before the induction of anaesthesia (“sign in”), before the incision of the skin (“time out”) and before the patient leaves the operating room (“sign out”). Previous studies of the use of the WHO Checklist have found increased surgical efficiency; as well as, positive safety culture and improved safety and team communication. Other work has also identified a number of barriers to compliance (e.g., the checklist is sometimes perceived as time consuming and lack of team/management ‘buy-in’ may hamper its adoption – Russ et al., 2015). The present study describes a case study examining a set of barriers and enablers of compliance of the WHO checklist at a major hospital based in the West Midlands.