SynthesisBMC health services research2025
Beyond compliance: examining the completeness and determinants of WHO surgical safety checklist - a systematic review and meta-analysis.
Synthesis in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
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Who cites it
10 citing papers in PubMed.
- The mirrored burden and accountable handovers in cancer survivorship: co‑designing a post‑treatment transition standard.npj health systems · 2026Article
- Article
- Adherence to the WHO surgical safety checklist at Tibebe Ghion Specialized Hospital, Ethiopia: a prospective observational study.BMC surgery · 2026Observational
- Attitudes Toward Patient Safety in Operating Rooms: Cross-Cultural Adaptation and Validation of the French Version of the Operating Room Management Attitudes Questionnaire (ORMAQ).Healthcare (Basel, Switzerland) · 2026Article
- Identified practice gaps and opportunities in anesthesia safety across 14 Arab countries: a multicenter study.Patient safety in surgery · 2026Article
- Perioperative nursing process-oriented bundled interventions and digital monitoring for the prevention of surgical site infections.Frontiers in medicine · 2026Review
- Surgical safety checklist implementation in a post-armed conflict country with limited resources: the Somali experience.Patient safety in surgery · 2025Article
- Interventions to Improve Compliance to Surgical Safety Checklist Use: Before-and-After Study at a Tertiary Public Hospital in Croatia.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Transforming surgical care and safety: dissecting the impact of checklists in the global south.Frontiers in surgery · 2025Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this systematic review and meta-analysis was to assess the compliance, completeness, and key barriers to the successful initiation and implementation of checklists in surgical theaters.Methods This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure the accuracy and reliability of the included studies. The protocol was registered in PROSPERO (CRD42024589344).Results The review included 13 observational studies conducted globally, encompassing a total of 17,867 participants. The overall compliance rate with the World Health Organization Surgical Safety Checklist was 73% (95% CI: 62-85%). Compliance rates for individual components were 76% for "Sign In," 61% for "Time Out," and 62% for "Sign Out." The overall completeness of checklist implementation was 51%. Factors that improve compliance rate include prior Surgical Safety Checklist exposure, training, a positive work environment, management support, and regular monitoring with feedback. Conversely, barriers such as insufficient staffing, high workloads, lack of checklist ownership, resistance to change, weak audit systems, and rapid staff turnover hinder effective implementation and compliance.Conclusion Despite the importance of Surgical Safety Checklist in improving healthcare outcomes, its overall compliance rate across healthcare settings remains suboptimal, with a notably low completeness rate. This highlights the frequent omission or inconsistent application of critical checklist components. Maximizing the checklist's full potential requires continuous efforts, including sustained support, regular audit, and strong commitment from all stakeholders.Recommendation Policymakers, healthcare administrators, and surgical teams must work together to integrate the checklist into routine workflows, ensure continuous monitoring and support, and foster a culture of safety to improve patient outcomes.
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