Surgical safety checklist audits may be misleading! Improving the implementation and adherence of the surgical safety checklist: a quality improvement project
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    SSCL adherence

    The authors have provided an admirable example of how the SSCL utilization can be improved via a dedicated and sustained effort. In some ways I wish they had been able to provide a pathway that didn't involve so many steps, as I think their observation that 'administrative' vs 'real' view of success of SSCL process is probably greatly wrong - it was in our hospital too.
    In our hospital the OR record is where the SSCL process is recorded and quite often the "briefing", "time-out" and "debriefing" components were "ticked" at a random time, often before they might actually have taken place. A four page form with a couple of hundred entries does not lend itself to accuracy!
    I was disappointed in their reported revision of the actual checklist. I thought it was still overlong, and I didn't feel it adequately reflected the most important point about the SSCL process, which is to develop a team from what is an often changing group of individuals, and thusly to engage all of the OR staff in the process.
    They state "the number of items on the form decreased from 21 to 19". I count 26 separate questions requiring responses. Gawande in The Checklist Manifesto" suggests that 5 or 7 is the optimal number of questions - less being better. This form has more and I do question whether they are all "necessary" in contributing to teamwork and safety.
    As a couple of...

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    Conflict of Interest:
    None declared.