ArticleThe British journal of surgery2019
Implementation and evaluation of nationwide scale-up of the Surgical Safety Checklist.
Article in The British journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prospective application of theoretical implementation frameworks to improve health care in hospitals - a systematic review.BMC health services research · 2023Pooled it
- Pooled it
- Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review.Implementation science : IS · 2020Pooled it
- Towards sustaining a trauma quality improvement initiative in Ghana: results of a clinical trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Trial
- The Use of the WHO Surgical Safety Checklist in the Democratic Republic of the Congo: A Exploratory Survey.Health science reports · 2026Article
- Patient safety culture in the operating room of African hospitals: a systematic review.Patient safety in surgery · 2026Review
- Protocol for implementation of intraoperative adverse event recording during WHO checklist sign-out.BMJ open quality · 2025Article
- Systematic recording and discussion of intraoperative adverse events using ClassIntra: results of a qualitative context analysis before implementation.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
- Assessing use of the WHO surgical safety checklist for pediatric surgery in Senegal: A nationwide survey.Global journal on quality and safety in healthcare · 2025Article
- Transforming surgical care and safety: dissecting the impact of checklists in the global south.Frontiers in surgery · 2025Review
- Implementation of an electronic health record system during global surgical outreach: A prospective evaluation of success and sustainability.World journal of surgery · 2024Article
- Implementing a modified neurology objective structured clinical examination during the COVID-19 pandemic: an implementation science perspective.Singapore medical journal · 2024Article
- Evaluating the uptake and effect of Surgical Safety Checklist implementation in a rural hospital, Neno District, Malawi.BMJ open quality · 2023Article
- Pulse oximetry training landscape for healthcare workers in low- and middle-income countries: A scoping review.Journal of global health · 2023Article
- Multifaceted implementation and sustainability of a protocol for prehospital anaesthesia: a retrospective analysis of 2115 patients from helicopter emergency medical services.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research.Implementation science communications · 2023Article
- Scaling up of safety and quality improvement interventions in perioperative care: a systematic scoping review of implementation strategies and effectiveness.BMJ global health · 2022Article
- Utilization and Completeness of Surgical Safety Checklist with Associated Factors in Surgical Units of Jimma University Medical Center, Ethiopia.International journal of general medicine · 2022Article
- A guide to systems-level, participatory, theory-informed implementation research in global health.BMJ global health · 2021Article
- The surgical safety checklist: a quantitative study on attitudes and barriers among gynecological surgery teams.BMC health services research · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe WHO Surgical Safety Checklist improves surgical outcomes, but evidence and theoretical frameworks for successful implementation in low-income countries remain lacking. Based on previous research in Madagascar, a nationwide checklist implementation in Benin was designed and evaluated longitudinally.
methodsThis study had a longitudinal embedded mixed-methods design. The well validated Consolidated Framework for Implementation Research (CFIR) was used to structure the approach and evaluate the implementation. Thirty-six hospitals received 3-day multidisciplinary training and 4-month follow-up. Seventeen hospitals were sampled purposively for evaluation at 12-18 months. The primary outcome was sustainability of checklist use at 12-18 months measured by questionnaire. Secondary outcomes were CFIR-derived implementation outcomes, measured using the WHO Behaviourally Anchored Rating Scale (WHOBARS), safety questionnaires and focus groups.
resultsAt 12-18 months, 86·0 per cent of participants (86 of 100) reported checklist use compared with 31·1 per cent (169 of 543) before training and 88·8 per cent (158 of 178) at 4 months. There was high-fidelity use (median WHOBARS score 5·0 of 7; use of basic safety processes ranged from 85·0 to 99·0 per cent), and high penetration shown by a significant improvement in hospital safety culture (adapted Human Factors Attitude Questionnaire scores of 76·7, 81·1 and 82·2 per cent before, and at 4 and 12-18 months after training respectively; P < 0·001). Acceptability, adoption, appropriateness and feasibility scored 9·6-9·8 of 10. This approach incorporated 31 of 36 CFIR implementation constructs successfully.
conclusionThis study shows successfully sustained nationwide checklist implementation using a validated implementation framework.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.