Comparison of compliance and quality in administration of the WHO Surgical Safety Checklist in two Auckland hospitals.

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The World Health Organisation (WHO) has developed an airline cockpit-style checklist to make surgery safer by reducing errors and improving team work in the operating room. A study from eight centres world-wide showed that the Checklist reduced patient harm and actually saved lives. In 2010 a tool was developed to allow an independant observer to record compliance and quality in administration of the checklist during an episode of surgery. We received expedited ethics approval to use this tool to audit 100 surgical cases at a large Auckland hospital. Compliance proved to be good in administering some items of the checklist, and poor with respect to others. It was also determined that there was considerable potential to improve engagement by theatre teams during the process of administration. Anecdotally (observations by surgeons who work at other large Auckland hospitals) there may be better compliance and engagement associated with different methods of administration. Therefore we propose to observe a random selection of operations at two large hospitals using exactly the same methodology as our previous study. Agreement will be obtained from all relevant clinical teams. 100 operative procedures will be audited at each hospital. This study will inform a process of continuous quality improvement aimed at enhancing safety in the operating room. No information that will identifies any staff or patients from the audited surgical cases will be gathered.