# Adapting the modified WHO safety checklist for non-operating room anesthesia: A Quality improvement project

## TL;DR

This study shows how adapting a WHO safety checklist improved patient safety during non-surgical procedures in a radiology department.

## Contribution

A modified WHO safety checklist tailored for radiology was developed and shown to achieve full compliance with safety standards.

## Key findings

- Initial audit found no use of safety checklists in 30 patients, violating RCR standards.
- After implementing a modified checklist, re-audit showed 100% compliance in 55 patients.
- Tailored checklists and regular audits can close safety gaps in non-operating room anesthesia.

## Abstract

Patient safety checklists are established tools for reducing preventable errors in clinical practice. The use of World Health Organization (WHO) safety checklist outside the operating room environment remains inconsistent. This audit was conducted to assess compliance with the Royal College of Radiologists (RCR) standards.

A prospective audit by the anesthesia team was carried out in the Radiology Department of Shaukat Khanum Memorial Cancer Hospital and Research Center, Peshawar. All patients receiving sedation for CT, MRI, or PET scans in February 2023 were included (n=30). Data sources included patient records, resuscitation equipment logs, drug inventory checks, staff training records, and direct observations. Standards were benchmarked against Royal College of Radiologists (RCR) recommendations. Audit findings were presented to the Quality Council, and a modified WHO safety checklist specific to radiology was developed and implemented. A re-audit was latter conducted in March–April 2024 which included 55 patients.

Baseline data demonstrated compliance with all RCR standards except for the use of a safety checklist, which was absent in all 30 cases. In response, a concise modified WHO checklist was introduced, incorporating high-risk patient identification and independent double-checking of medications. The re-audit showed 100% compliance across all RCR indicators, including checklist use, in 55 patients.

The adaptation of the modified WHO safety checklist for radiology enhanced compliance with international safety standards and closed previously identified gaps. Regular clinical audits and the incorporation of tailored checklists can strengthen patient safety in non-operating room anesthesia.