What are the barriers to the implementation of the WHO Surgical Safety Checklist?

• Staff attitudes
• Time constraints
• Poor leadership
• Lack of support from management
• Hierarchy in theatres discourages clear communication
• Poor example set by colleagues
• Staff shortages; absence of key members of the team, e.g. surgeon
• Confusion over who is responsible
• Lack of knowledge
• Embarrassment about introductions
• Lack of engagement, dismissive attitude
• Seen as a ‘tick box’ exercise

How could these barriers be managed/removed to ensure successful implementation of the WHO Surgical Safety Checklist?

• Education
• Raise awareness of importance of WHO Surgical Safety Checklist
• Good leadership
• Time to complete
• Role modelling; local champions
• Audit to assess compliance
• Clear policy and procedure