Table 4.
Compliance with the WHO Surgical Safety Checklist items
| Item | Site A | Site B | Site C | Site D | Site E | Total | |
|---|---|---|---|---|---|---|---|
| Sign-in’ phase | Has the patient confirmed his/her identity, site, the procedure and consent | 100.0% | 100.0% | 98.0% | 100.0% | 100.0% | 99.5% |
| Is the site marked | 96.5% | 80.0% | 97.5% | 100.0% | 100.0% | 97.2% | |
| Is the anesthesia machine and medication check complete | 100.0% | 100.0% | 81.5% | 100.0% | 100.0% | 95.7% | |
| Is the pulse oximeter on the patient and functioning | 100.0% | 95.0% | 96.0% | 100.0% | 100.0% | 98.7% | |
| Known allergy | 100.0% | 100.0% | 95.5% | 100.0% | 100.0% | 99.0% | |
| Difficult airway or aspiration risk | 87.5% | 0.0% | 74.5% | 100.0% | 99.0% | 84.0% | |
| Risk of >500 ml blood loss | 97.5% | 63.3% | 70.5% | 100.0% | 99.0% | 89.9% | |
| Overall ‘sign-in’ | 94.8% | ||||||
| Time-out’ phase | Confirm all team members have introduced themselves by name and role | 2.0% | 0.0% | 0.0% | 6.0% | 0.0% | 1.9% |
| Confirm the patient’s name, procedure and where the incision will be made | 100.0% | 100.0% | 79.5% | 100.0% | 93.0% | 93.6% | |
| Has antibiotic prophylaxis been give within the last 60 min | 100.0% | 100.0% | 92.0% | 100.0% | 100.0% | 98.1% | |
| What are the critical or non-routine steps | 22.5% | 25.0% | 62.0% | 100.0% | 10.0% | 47.0% | |
| How long will the case take | 25.0% | 85.0% | 79.0% | 100.0% | 11.0% | 55.9% | |
| What is the anticipated blood loss | 23.5% | 65.0% | 80.5% | 100.0% | 8.0% | 53.8% | |
| Are there any patient-specific concerns | 20.0% | 60.0% | 73.0% | 100.0% | 100.0% | 72.3% | |
| Has sterility been confirmed | 100.0% | 50.0% | 77.5% | 100.0% | 100.0% | 91.3% | |
| Are there equipment issues or any concerns | 98.5% | 65.0% | 77.5% | 100.0% | 100.0% | 92.0% | |
| Is essential imaging displayed | 98.0% | 85.0% | 95.0% | 100.0% | 100.0% | 97.3% | |
| Overall ‘time-out’ | 70.3% | ||||||
| Sign-out’ phase | The name of the procedure | 97.50% | 100% | 98% | 100% | 100% | 98.9% |
| Completion of instrument, sponge and needle counts | 100% | 100% | 96.50% | 100% | 100% | 99.2% | |
| Specimen labelling | 99% | 75% | 97.50% | 100% | 100% | 97.4% | |
| Whether there are any equipment problems to be addressed | 83.50% | 0% | 0% | 100% | 100% | 65.9% | |
| What are the key concerns for recovery and management of this patient | 7% | 10% | 0% | 100% | 11% | 28.1% | |
| Overall ‘sign-out’ | 77.9% | ||||||
| Average compliance (all items) | 75.3% | 66.3% | 73.7% | 95.7% | 78.7% | 79.8% | |
| Average compliance (for items in both WHO SSC and MoH SSC) | 81.2% | 81.4% | 86.9% | 100.0% | 83.6% | 87.4% | |
| Average compliance (for items only in WHO SSC) | 55.5% | 14.7% | 29.0% | 81.2% | 61.8% | 53.9% | |
| Proportion of items reaching 100% compliance | 8/22 | 7/22 | 0/22 | 21/22 | 15/22 |
WHO World Health Organisation, MoH Chinese Ministry of Health, SSC Surgical Safety Checklist