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Renewed calls for widespread use of the Surgical Safety Checklist

by | Friday, November 3, 2017

Surgical Safety Checklist

The Surgical Safety Checklist (SSCL) is a vital tool that was introduced in by the World Health Organization in 2008 and followed by the Canadian Patient Safety Institute in 2009, that can improve the safety of surgery, thereby reducing patient harm and death. In 2010, the SSCL was recognized by Accreditation Canada as an essential component to patient safety.

Fundamentally, the SSCL is a series of questions a surgical team reviews at three distinct times:

  1. Briefing: before the use of anesthesia;
  2. Time Out: before the first incision is made; and
  3. Debriefing: before a patient leaves the operating room.

As well as ensuring standard steps are followed, the SSCL can improve anaesthetic safety practices, ensure correct site surgery, avoid surgical site infections and foster better communication between members of a surgical team, which has been shown to improve patient safety.

Profiling Surgical Errors in Canada

The article “Safe Surgery: Closing the gap with the surgical safety checklist”, published by the Canadian Medical Protective Association earlier this year, discusses a peer expert review of 54 closed medical-legal cases with SSCL-related issues. In many of these 54 cases, surgical safety processes were found to be inadequate, non-existent, or not followed by the OR team.

The article further notes that “almost two-thirds of the surgical incidents (35/54 cases) occurred during the briefing or time-out phase, and the remaining ones occurred during debriefing (i.e. before the patient left the OR)”.

The Surgical Safety in Canada Report provides statistics regarding surgical error on a much broader scale. Released in 2016, this report notes that more than one million surgical procedures were performed annually in Canada between 2004 and 2013. Moreover, more than half of all patient safety incidents in healthcare are attributed to surgical care.

Renewed calls for widespread use of the Surgical Safety Checklist

The Canadian Patient Safety Institute (CPSI), Alberta Health Services (AHS), Canadian Anesthesiologists’ Society (CAS), and Operating Room Nurses Association of Canada (ORNAC) have recently released a Joint Position Statement entitled “Advocacy and Support for the Surgical Safety Checklist”. This statement renewed calls for the SSCL to be an integral component of every surgical procedure in Canada.

While the SSCL will not prevent all incidents of surgical error, its widespread implementation and use can enhance surgical safety, and reduce the risk of adverse events arising from surgery in Canada.

If you or a loved one has been injured by surgical error, please contact Wagners at 902 425 7330, toll-free at 1 800 465 8794 or via email at

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