Problems and Countermeasures in the Practical Use of the WHO Surgical Safety Checklist：Comprehensive Management by Operating Team Protects Surgical Patients

A modified version of the WHO surgical safety checklist（CL）was implemented in April 2012 at our hospital. We investigated yearly changes before and after the CL’s implementation in the sum of incident reports submitted with operations, comprehensively evaluated the CL through a questionnaire survey of health care providers, and investigated problems and their countermeasures in the practical use of the CL.Over the 5 year study period, claims of harmful injury to patients diminished after implementing the CL, especially during the first 3 years after implementation, when we had no “never events” such as patient misconception, wrong surgical site, errors in operation methods and so on. In the comprehensive evaluation of the CL by health care providers（medical doctors and nurses）, positive evaluations of the CL ranged from 87% to 100%.Problems in the practical use of the CL such as becoming a mere name at time-out, the necessity of complete enforcement of 3 phases（sign-in, time-out, sign-out）, and whether or not we ought to implement CL in emergency situations were identified through the questionnaire.The WHO’s CL is essential to ensure patient safety and is expected to be a tool which nurtures a safety culture in the field of operative medicine.