ArticleRisk management and healthcare policy2025
Improving Surgical Safety in Somalia a Closed-Loop Audit Study of WHO Surgical Safety Checklist Adherence.
Article in Risk management and healthcare policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Challenges for implementation of "Enhanced Recovery After Surgery" (ERAS) protocols and artificial intelligence support tools in resource-limited countries.Patient safety in surgery · 2026Article
- Minimum Procedural Volume Thresholds for Surgical Privileging: A Mixed-Methods Validation and Risk Management Framework in a Multi-Specialty Healthcare Network.Risk management and healthcare policy · 2026Article
- The State of Anesthesia and Critical Care Services in Somalia: Challenges and Opportunities.Risk management and healthcare policy · 2026Article
- Strengthening Surgical Safety in Somalia: The Role of Scrub Nurses in Infection Prevention and Team Communication in Resource-Limited Operating Theatres.Journal of multidisciplinary healthcare · 2026Article
- Artificial Intelligence and Enhanced Recovery After Surgery as Patient Safety Strategies for Perioperative Care in Resource-Limited Settings.Risk management and healthcare policy · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Surgical safety is a global health priority, yet its consistent application in low- and middle-income countries remains a challenge due to systemic, cultural, and resource-related barriers. The World Health Organization's Surgical Safety Checklist (SSC) has been shown to reduce perioperative complications, but evidence from fragile health systems such as Somalia remains scarce. Methods: This prospective closed-loop clinical audit was conducted at Dr. Sumait Hospital, a tertiary referral and teaching facility in Mogadishu, Somalia. A total of 160 surgical procedures were observed across two audit cycles. The first cycle established baseline compliance, while the second followed a structured intervention comprising targeted staff education sessions, strengthened leadership involvement, and placement of visual reminders and wall posters in operating theatres. Checklist adherence was assessed across the sign in, time out, and sign out phases using a standardized 25-item observation tool. Data were analyzed using the Wilcoxon signed-rank test, with significance set at p < 0.05. Results: Overall checklist compliance increased significantly from 51.38% in the first cycle to 93.01% in the second (p < 0.001). Improvements were observed across all three SSC phases: sign in compliance rose from 54.62% to 88.19%, time out compliance from 50.60% to 96.94%, and sign out compliance from 47.29% to 95.01%. The most substantial gains were linked to improved team communication during the time out phase. However, checklist items requiring anticipatory planning, such as risk assessment for major blood loss, showed relatively lower improvements. Conclusion: Context-sensitive, low-cost interventions-including focused education, leadership reinforcement, and visual prompts-can markedly improve adherence to the WHO Surgical Safety Checklist in resource-limited settings. These findings underscore the SSC's potential to strengthen surgical safety culture in Somalia and offer a practical model for similar fragile health systems aiming to reduce preventable perioperative harm.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.