Evaluating the WHO Surgical Safety Checklist Compliance at Level 1 Trauma Centre, India: A Descriptive Study

Implementation of the World Health Organization (WHO) Surgical Safety Checklist (SSC) has been associated with improved surgical outcomes by addressing critical processes during the perioperative period. Despite its proven benefits, compliance with the SSC remains a challenge in high-risk surgical settings. The primary objective of our study was to evaluate the compliance with WHO SSC parameters across various surgical disciplines in a level 1 trauma centre of a tertiary care hospital and to provide recommendations for improving the compliance and overall effectiveness. A descriptive study was conducted from January 2021 to December 2023 at Apex Trauma Centre, Delhi, India. Data on SSC implementation was collected from 400 randomly selected surgical cases across the four surgical disciplines at trauma centre. Compliance was assessed for the three phases of the checklist, i.e. sign-in, time-out, and sign-out. Non-compliances to the SSC components were noted and data was analysed using SPSS software version 21.0. Compliance with the sign-in phase was high, with most items achieving compliance rates above 95%. The time-out phase showed varied compliance, with rates for team introductions and verbal confirmations ranging from 86 to 97%. The sign-out phase had the lowest compliance rates, particularly for instrument counts and specimen labelling, which were as low as 16%. Overall, the study highlighted high compliance with preoperative preparations but identified significant gaps in the intraoperative and postoperative checklist adherence. Continued education, integrating dedicated checklist coordinators, fostering teamwork, and implementing regular audits and feedback mechanisms are recommended to improve adherence and surgical outcomes.