[Implementation strategy of the HAS French surgical check-list in a university hospital]

The check-list (CL) "Safety in Operating Room" has been introduced in our teaching hospital since 2009, associated to a "Quality and Prevention of Risks" program. This introduction was carried out over two distinct phases. The first one was a pilot start including five OR, allowing us to draw firm recommendations on the best way to perform the introduction, followed by a generalization to the other operating room (OR). The recommendations were the followings: a pilot committee including all the professionals should be constituted before the onset of introduction, a dedicated communication should focus on the actual concerns and benefits, and finally, the person questioning other care givers and filling the form should be clearly identified and supported in the OR. Meanwhile a guide on the utilization of the CL in each surgical speciality was written, and a dedicated manager was in charge of the whole procedure. This experience raised several remarks. This implementation of the CL proved to be a cause of self-interrogation on our medical practices, and the opportunity to improve communication among the professionals of the OR. Indeed, the 10 items of the OR should be thought as the last check before the no-return point, which should be shared by anyone in the OR. If these conditions were fulfilled, the CL could be viewed as an actual improvement of safety in the OR. Otherwise, CL is just a supplementary form.