ArticlePatient safety in surgery2021
Attitudes and compliance with the WHO surgical safety checklist: a survey among surgeons and operating room staff in 138 hospitals in China.
Article in Patient safety in surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Beyond compliance: examining the completeness and determinants of WHO surgical safety checklist - a systematic review and meta-analysis.BMC health services research · 2025Pooled it
- Adherence to the WHO surgical safety checklist at Tibebe Ghion Specialized Hospital, Ethiopia: a prospective observational study.BMC surgery · 2026Observational
- The creation of a pediatric surgical checklist for adult providers.BMC health services research · 2024Review
- Does the WHO Surgical Safety Checklist Need Modification for Orthopaedic Surgery Practices? A Cross-Sectional Survey Among Indian Orthopaedic Surgeons.Indian journal of orthopaedics · 2024Article
- Compliance with the World Health Organization's surgical safety checklist and related postoperative outcomes: a nationwide survey among 172 health facilities in Ethiopia.Patient safety in surgery · 2022Article
- Compliance with the surgical safety checklist in Switzerland: an observational multicenter study based on self-reported data.Patient safety in surgery · 2022Article
- Intraoperative practices to prevent wrong-level spine surgery: a survey among 105 spine surgeons in the United Kingdom.Patient safety in surgery · 2022Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTen years after the introduction of the Chinese Ministry of Health (MoH) version of Surgical Safety Checklist (SSC) we wished to assess the ongoing influence of the World Health Organisation (WHO) SSC by observing all three checklist components during elective surgical procedures in China, as well as survey operating room staff and surgeons more widely about the WHO SSC.
methodsA questionnaire was designed to gain authentic views on the WHO SSC. We also conducted a prospective cross-sectional study at five level 3 hospitals. Local data collectors were trained to document specific item performance. Adverse events which delayed the operation were recorded as well as the individuals leading or participating in the three SSC components.
resultsA total of 846 operating room staff and surgeons from 138 hospitals representing every mainland province responded to the survey. There was widespread acceptance of the checklist and its value in improving patient safety. 860 operations were observed for SSC compliance. Overall compliance was 79.8%. Compliance in surgeon-dependent items of the 'time-out' component reduced when it was nurse-led (p < 0.0001). WHO SSC interventions which are omitted from the MoH SSC continued to be discussed over half the time. Overall adverse events rate was 2.7%. One site had near 100% compliance in association with a circulating inspection team which had power of sanction.
conclusionThe WHO SSC remains a powerful tool for surgical patient safety in China. Cultural changes in nursing assertiveness and surgeon-led teamwork and checklist ownership are the key elements for improving compliance. Standardised audits are required to monitor and ensure checklist compliance.
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