World Health Organization Surgical Safety Checklist

Over the last two centuries, the safety and ease of surgery has dramatically improved. With the availability of anesthesia, antisepsis and other medical advancements, more and more  operations are performed globally. Each year, there is one operation for every 25 individuals worldwide, and the average American can expect to undergo seven operations during his or her lifetime. As an intervention that can address a large portion of the global burden of disease, surgery plays an important role in public health. Whether used in injury management, cancer treatment, or maternal and child health, surgery is one of public health’s most critical, high stakes moments for ensuring safe, quality care.

Even with great improvements in medical care, surgery still presents a significant risk of patient harm due to surgical complications. Much of this risk can be avoided when surgical teams follow proven patient safety practices.

Ariadne Labs has led the global effort to standardize safety measures in operating rooms through the development of the Surgical Safety Checklist, which was originally developed by a team led by our founder and executive director, Dr. Atul Gawande, and founding chief medical officer, Dr. Bill Berry. In 2008, the World Health Organization (WHO) adopted the Surgical Safety Checklist as the global standard of care. The Surgical Safety Checklist became the core program of Ariadne Labs in 2012.

The checklist identifies three critical pause points for surgery:

  1. before the induction of anesthesia,
  2. before the incision in the skin and
  3. before the patient leaves the operating room.

At each pause point, the checklist encourages preparation, communication and adherence to important practices that reduce errors and help surgical teams work together better. By using the checklist to build effective communication and teamwork, surgical teams can minimize the most common and avoidable risks endangering the lives and well-being of their patients.

Today, Ariadne Labs collaborates with hospitals and medical facilities around the world to implement, evaluate and adapt the checklist. More work remains to disseminate the checklist in diverse settings.

Development of the Checklist
Testing the Checklist
Spreading the Checklist