Perspectives in quality: designing the WHO Surgical Safety Checklist

TLDR

The WHO Patient Safety Programme launched an initiative to improve surgical safety worldwide, noting a lack of guidance on medical checklist creation while drawing on the aviation industry's 70+ years of checklist experience. The authors aimed to develop a universal surgical safety checklist by applying aviation‑derived lessons to support essential clinical practice and to outline a methodology for future health‑care checklists. They created the checklist by selecting items that could and should be practiced in all surgical settings, incorporating aviation principles, and reviewing the development process to highlight differences between aviation and medicine. They reviewed how aviation lessons were applied and discussed differences between aviation and medicine that affect checklist use in health care.

Abstract

The World Health Organization's Patient Safety Programme created an initiative to improve the safety of surgery around the world. In order to accomplish this goal the programme team developed a checklist with items that could and, if at all possible, should be practised in all settings where surgery takes place. There is little guidance in the literature regarding methods for creating a medical checklist. The airline industry, however, has more than 70 years of experience in developing and using checklists. The authors of the WHO Surgical Safety Checklist drew lessons from the aviation experience to create a safety tool that supports essential clinical practice. In order to inform the methodology for development of future checklists in health care, we review how we applied lessons learned from the aviation experience in checklist development to the development of the Surgical Safety Checklist and also discuss the differences that exist between aviation and medicine that impact the use of checklists in health care.