Patient safety

WHO surgical safety checklist and implementation manual

World Alliance for Patient Safety

Safe surgery checklist and implementation manual

Publication details

Number of pages: 1
Publication date: 2008
Languages: English



Surgical care has been an essential component of health care worldwide for over a century. As the incidences of traumatic injuries, cancers and cardiovascular disease continue to rise, the impact of surgical intervention on public health systems will grow.

WHO has undertaken a number of global and regional initiatives to address surgical safety. The Global Initiative for Emergency and Essential Surgical Care and the Guidelines for Essential Trauma Care focussed on access and quality. The Second Global Patient Safety Challenge: Safe Surgery Saves Lives addresses the safety of surgical care. The World Alliance for Patient Safety initiated work on the Challenge in January 2007.

The focus of the Challenge is the WHO Safe Surgery Checklist. The checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work: Before the induction of anaesthesia (“sign in”), before the incision of the skin (“time out”) and before the patient leaves the operating room (“sign out”). In each phase, a checklist coordinator must confirm that the surgery team has completed the listed tasks before it proceeds with the operation.

The manual provides suggestions for implementing the checklist, understanding that different practice settings will adapt it to their own circumstances.

The implementation manual is designed to help ensure that surgical teams are able to implement the checklist consistently. By following a few critical steps, health care professionals can minimize the most common and avoidable risks endangering the lives and well-being of surgical patients.

The Safe Surgery Saves Lives initiative is also working to promote surgical improvement programs and collaboration by building a network of users. For more information on how to participate in this process, please visit the campaign page.