Variation in the Global Uptake of the Surgical Safety Checklist

on behalf of the Surgical Outcomes Study Groups and GlobalSurg Collaborative

Research output: Contribution to journalArticlepeer-review



The Surgical Safety Checklist (SSC) is a patient safety tool shown to reduce mortality and improve teamwork and adherence with perioperative safety practices. The results of the original pilot work were published 10 years ago. This study aims to determine the contemporary prevalence and predictors of SSC use globally.
Pooled data from the GlobalSurg and Surgical Outcomes studies were analyzed to describe SSC use from 2014-2016. The primary exposure was Human Development Index (HDI) of the reporting country and the primary outcome was reported SSC use. A generalized estimating equation, clustering by facility, was used to determine differences in SSC use by patient, facility, and national characteristics.
A total of 85,957 patients from 1,464 facilities in 94 countries were included. On average, facilities used the SSC in 75.4% of operations. Compared to very high HDI, SSC use was less in low HDI countries (OR 0.08, 95% CI 0.05-0.12). The SSC was used less in urgent compared to elective operations in low HDI countries (OR 0.68, 95% CI 0.53-0.86) but used equally in urgent and elective operations in very high HDI countries (OR 0.96, 95% CI 0.87-1.06). SSC use was lower obstetrics and gynaecology versus abdominal surgery (OR 0.91, 95% CI 0.85-0.98) and where the common or official language was not one of the WHO official languages (OR 0.30, 95% CI 0.23-0.39).
Worldwide, SSC use is generally high, but significant variability exists. Implementation and dissemination strategies must be developed to address this variability.
Original languageEnglish
JournalBritish Journal of Surgery
Issue number2
Early online date5 Jan 2020
Publication statusPublished - Jan 2020


Dive into the research topics of 'Variation in the Global Uptake of the Surgical Safety Checklist'. Together they form a unique fingerprint.

Cite this