The World Health Organisation has devised a new safety checklist designed to help cut the number of preventable surgical complications and deaths. 

Currently, the checklist is only available on paper, but its developer Professor Atul Gawande of Harvard University, told E-Health Europe, that work was underway to create an electronic version.

The checklist identifies three phases of an operation – the first is checked before a patient is offered anaesthesia, known as ‘Sign In’.

Checks are then made before any skin incisions, known as ‘Time Out’ and before the patient leaves the operating room, known as ‘Sign Out’.

In each phase a checklist coordinator must be permitted to confirm that the team has completed its tasks before it proceeds with the operation.

“The checklist has been designed to be as simple as possible. As it asks few questions, it can easily be adapted for electronic use. Many developed nations use computer systems in their operating theatres, and we are encouraging vendors of these to design an electronic version of the checklist and incorporate into the system,” he said.

The checklist has been designed as part of the WHO’s ‘Safe Surgery Saves Lives’ initiative – a collaborative effort led by the Harvard School of Public Health involving more than 200 national and international medical societies and ministries of health.

Its primary aim is to target the three biggest cause of mortality in surgery – preventable infections, preventable complication from bleeding, and safety in anesthesia.

Chair of the World Alliance for Patient Safety, Professor Liam Donaldson, told EHE: “These vital checks are not systematically performed everywhere, and vital checks are not made before, during or after surgery.

“With the checklist, these factors will be incorporated into standard operating room procedures globally and will be formally checked to cut down on unnecessary problems in operating rooms globally.”

Professor Donaldson said the checklist may be incorporated into electronic medical records in the future.

“Electronic medical records and components such as e-prescribing can reduce the risk of fatal errors. At this stage, it is premature to say if we will ask vendors to add this checklist to their products, as we are just trialling the new list. However, it’s fair to say that in the future IT may well prove to be the way forward for preventing issues like unnecessary surgical complications.”

The new checklist is now being piloted by eight pilot sites across the world.

He said: "I feel confident that the introduction of the surgical safety checklist will improve the safety of patients who undergo surgery in the UK."

The WHO estimates that up to 16% of surgical procedures in industrial nations result in major complications. In developing countries the death rate during major surgery is estimated to be as high as 10%.


WHO checklist