Surgical safety checklists: making team pauses work in practice

The purpose is a shared pause

The WHO checklist separates checks before anaesthesia, before incision and before the patient leaves the operating room. ^[1] The process should fit those moments rather than become retrospective paperwork. Its value depends on giving the team an opportunity to identify unresolved concerns before proceeding.

Implementation requires a team

WHO identifies engagement, leadership, local champions, training, multidisciplinary work, coaching, feedback and local adaptation as implementation factors. ^[2] Its resources also emphasize verbal confirmation and team participation during the pauses. ^[3]

An ICORP implementation proposal

Rehearse the workflow with surgery, anaesthesia and nursing staff. Agree who coordinates each pause and how concerns are escalated before the next step. Observe whether each profession can contribute, then improve tool placement and the sequence of discussion. Do not remove safety content merely to produce a faster completion time.

Observe the conversation

Suggested measures include whether checks occur at the intended stage, the relevant team participates and identified concerns are addressed. Combine direct observation with records and staff feedback. Completion percentages alone do not show how the team communicated. This article neither promises prevention of every adverse event nor replaces local surgical or anaesthetic protocols.