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Ambulatory Safe Surgery Checklist Template

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This checklist is designed for use in ambulatory surgery centers or for other low-risk procedures. It includes items for this type of surgery and omits items that are not applicable to the ASC environment.


Cardiac Surgery Checklist

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This checklist is designed to be used in Cardiac Surgery. It includes additional communication checks at critical times during cardiac procedures.


Safe Surgery Checklist Template (Team Already Knows Each Other)

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This checklist is designed to be used in facilities where the operating room teams are stable and everyone knows each other by name. Instead of introducing the team, we recommend that the surgeon activates everyone in the OR by asking each person by name, “Are ready to proceed?” prior to skin incision.


Safe Surgery Checklist Template (Team Briefing Before Induction)

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This template is designed for use in facilities where the surgeon is always present at the time of induction. If the surgeon is present at this time, it is recommended that the team conducts the briefing prior to induction.


Safe Surgery Checklist Template (Two Page)

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This template is ideal for organizations that wish to have the before induction of anesthesia portion of the checklist completed in the preoperative area with the anesthesia professional and nurse. This approach should only be used when the anesthesia professional and circulator are able to go to the pre-op area to review the checklist with the patient at the same time.


Safe Surgery Checklist Template (Master)

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This checklist template is designed for all three sections (Before induction of anesthesia, before skin incision, and before patient leaves the room) to be performed in the operating room. This checklist doesn’t preclude or change any of the existing routines you have in your preoperative area.


WHO Surgical Safety Checklist (Spanish)

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This 19 item checklist has shown to significantly reduce both morbidity and mortality. Along with decreasing errors and adverse events, it can increase teamwork and communication in surgery.


WHO Surgical Safety Checklist (French)

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This 19 item checklist has shown to significantly reduce both morbidity and mortality. Along with decreasing errors and adverse events, it can increase teamwork and communication in surgery.


A Checklist for Checklists

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This tool is designed to aid the checklist creation process and ensure your checklist helps instead of hurts.


WHO Surgical Safety Checklist (English)

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This 19 item checklist has shown to significantly reduce both morbidity and mortality. Along with decreasing errors and adverse events, it can increase teamwork and communication in surgery.