# Insights Into the Assessment of WHO-Recommended Practices Based on Surgical Operations in Tertiary Healthcare Settings

## TL;DR

This study evaluates how well WHO surgical safety checklists are followed in a hospital, finding that some steps need improvement.

## Contribution

The study provides a novel assessment of WHO checklist compliance in a tertiary healthcare setting using a qualitative questionnaire.

## Key findings

- The sign-out phase had the highest compliance at 88%, while the time-out phase had the lowest at 68%.
- Patient consent and sterilization protocols showed complete success rates.
- Training and awareness programs are recommended to improve checklist adherence.

## Abstract

Background: The protection of surgical safety comprises two major elements that produce the best outcomes for patients. The World Health Organization (WHO) created a surgical practice-based assessment for operative procedure-related risks. Medical professionals have proven the effectiveness of this checklist to eliminate both adverse outcomes and medical complications caused by surgical negligence.

Methodology: A study was conducted on 250 surgeries (major and minor) in a tertiary healthcare setting based on a qualitative questionnaire, adapted from the WHO checklist, operated through Google Forms. The examination spanned three months from September to November 2024. In accordance with WHO guidelines, the three surgical safety checklist phases - sign-in, time-out, and sign-out - were analyzed using SPSS version 20.0 (IBM Corp., Armonk, NY).

Results: The sign-out phase achieved the highest level of adherence, with 220 (88%) of surgical procedures using the checklist. The sign-in phase demonstrated 200 compliant cases (80%), whereas the time-out phase showed the lowest compliance, with only 170 cases (68%). Patient consent procedures, along with anesthesia protocols, instrument sterilization methods, and team member introduction protocols, all maintained complete success rates for ensuring a safe surgical space.

Conclusions: Implementing targeted awareness programs and training will help boost compliance rates with the WHO checklist, despite the current positive results.