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The introduction of a surgical safety checklist in a tertiary referral obstetric centre
  1. R J Kearns1,
  2. V Uppal1,
  3. J Bonner2,
  4. J Robertson3,
  5. M Daniel4,5,
  6. E M McGrady1
  1. 1Department of Anaesthesia, Princess Royal Maternity Unit, Glasgow Royal Infirmary, Glasgow, UK
  2. 2Department of Anaesthesia, Ninewells Hospital, Dundee, UK
  3. 3Department of Anaesthesia, Western Infirmary, Glasgow, UK
  4. 4Department of Anaesthesia, Pain and Critical Care Medicine, Glasgow Royal Infirmary, UK
  5. 5Health Foundation/Institute for Healthcare Improvement Fellow 2010–11, Cambridge, MA
  1. Correspondence to Dr R Kearns, Department of Anaesthesia, Princess Royal Maternity Unit, Glasgow Royal Infirmary, 2nd Floor, Walton Building, 91, Wishart Street, Glasgow G31 2HT, UK; rachel.harrison890{at}


Background Surgery-related adverse events remain a significant and often under-reported problem. In a recent study, the introduction of a perioperative checklist by the WHO reduced deaths and complications by 46% and 36% respectively. The authors wished to evaluate the introduction of a surgical safety checklist in a busy obstetric tertiary referral centre by assessing staff attitudes, checklist compliance and effects upon patients.

Methods A questionnaire-based assessment was performed on staff working in obstetric theatres before and after the introduction of the surgical safety checklist. Checklist compliance was assessed at 3 months and 1 year. Patients were asked questions relating to the performance of the surgical safety checklist in order to evaluate any anxiety caused.

Results Non-medical staff were significantly more likely than medical staff to feel familiar with other team members both before (p<0.001) and after (p=0.03) the introduction of the checklist. 69.6% of all staff felt that interprofessional communication had improved following the introduction of the checklist. Compliance with pre- and postoperative checks was 61.2% and 67.6%, respectively, improving to 79.7% and 84.7% after 1 year. Although the majority of patients were aware of the checks being performed, this did not provoke anxiety.

Conclusion Following consultation with staff and patients, the authors managed to institute and sustain the performance of a surgical safety checklist for elective cases in obstetric theatres. While significant progress has been made, the authors recognise that further work is required in order to further evaluate and optimise this process.

  • Patient safety
  • obstetrics
  • communication
  • healthcare quality improvement
  • patient safety
  • teamwork

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  • Presented in part at the Obstetric Anaesthesia 2010 Annual Meeting, Newcastle–Gateshead, UK.

  • Competing interests None.

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