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Mobilising or standing still?A narrative review of Surgical Safety Checklist knowledge as developed in 25 highly cited papers from 2009 to 2016
  1. Bethan Mitchell1,
  2. Sayra Cristancho2,
  3. Bryanna B Nyhof3,
  4. Lorelei A Lingard2
  1. 1 School of Social Sciences, University of Stirling, Stirling, UK
  2. 2 Centre for Education Research and Innovation, Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada
  3. 3 Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Sayra Cristancho, Centre for Education Research and Innovation, Western University Schulich School of Medicine and Dentistry, London, Ontario N6A 5C1, Canada; sayra.cristancho{at}

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The WHO Surgical Safety Checklist (SSC) was developed in 2008 as part of the Safe Surgery Saves Lives campaign.1 Broadly mandated and put into practice in hospitals around the world, the SSC has been the focus of 8 years of extensive research. Initial studies reported positive outcomes on morbidity and mortality.2 3 Other studies have reported more limited impacts, for example,4 still others have reported no impact at all5 6 or questioned the effectiveness of SSC.7 Such results have prompted calls for the reconsideration of policies mandating the SSC as an organisational safety practice.8

Much is at stake here. The role of team communication in care quality is incontrovertible9 10; therefore, decisions to pursue or abandon the SSC are consequential and should be made by drawing from a robust knowledge base. With the significant difficulties associated with progressively improving patient safety, the decision to abandon established and promising initiatives should be taken only after careful consideration of what has been achieved and a systematic assessment of what remains to be done.11 A multitude of studies, commentaries and reviews have been published since the introduction of the SSC, making this a good moment to pause and ask: how has knowledge mobilised and accumulated across high impact papers in the SSC literature?


Literature search and selection

Studies where the SSC was the central concern, available in English and published between 2009 and 2016 were included in the review (figure 1). Our search strategy focused on the term ‘surgical safety checklist’ and used the h-index* both from Web of Science and Scopus to help us identify highly impactful articles between 2009 and 2016. The first Web of Science search took place on 19 February 2016, and the h-index value was 25, where 25 articles were cited 25 times or more. …

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  • * The h-index was developed by J.E. Hirsch and published in Proceedings of the National Academy of Sciences of the United States of America 15 Nov 2005;102:16569–72.

  • Funding This work was supported by the Economic and Social Research Council (grant number ES/J500136/1).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with ‘BMJ Publishing Group’. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.