DOI: 10.1093/bjs/znad258.417 ISSN:

146 WHO Surgical Checklist Compliance and Attention Rates Among Different Specialties and Years

W H Ng, W Yeatman, D Kim, M Molyneux
  • Surgery



This study aims to evaluate the compliance of surgical staff to the WHO surgical safety checklist, excluding sign-out. The quality of surgical marks and inattentive rates of surgical staff during me-out were also investigated.


Data was collected over 3 weeks using a fixed criteria in September 2022 within 3 hospitals consisting of 5 sites. A total of 105 procedures were observed. Mean and confidence intervals were calculated using SPSS.


The mean compliance rate of the checklist was 97%. Sign-in (97%), Time-Out (96%), and Surgical mark rates (98%) all scored similarly.

Among specialties observed, interventional cardiology scored the highest compliance rates, at 100%, while cardiothoracic surgery scored the lowest at 91%. In 38% of procedures observed, surgical staff were found to be inattentive during me-out. Among the inattentive surgical staff, 73% of surgical staff had mild inattentiveness (e.g. filling up drug charts), 18% had moderate inattentiveness (e.g. talking to other staff), 9.1% of them had severe inattentiveness (e.g. scrubbing in).

Among the audit cycles from 2014 to 2022, there was an increase in sign-in rates from the previous cycle held in 2019 to 2022 from 82% to 97%. Inattentive rates increased from 33% in 2019 cycle to 38% in 2022 cycle.


This study reports high compliance rates and improvement with the checklist among all specialties, but also high inattentive rates by surgical staff. Improvements such as fostering a good culture among surgical staff on the WHO checklist and paying attention are key in never reducing events.

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