title: The WHO surgical safety checklist: survey of patients' views.
abstract: BACKGROUND
  Evidence suggests that full implementation of the WHO surgical safety checklist across NHS operating theatres is still proving a challenge for many surgical teams. The aim of the current study was to assess patients' views of the checklist, which have yet to be considered and could inform its appropriate use, and influence clinical buy-in.
  
  
  METHODS
  Postoperative patients were sampled from surgical wards at two large London teaching hospitals. Patients were shown two professionally produced videos, one demonstrating use of the WHO surgical safety checklist, and one demonstrating the equivalent periods of their operation before its introduction. Patients' views of the checklist, its use in practice, and their involvement in safety improvement more generally were captured using a bespoke 19-item questionnaire.
  
  
  RESULTS
  141 patients participated. Patients were positive towards the checklist, strongly agreeing that it would impact positively on their safety and on surgical team performance. Those worried about coming to harm in hospital were particularly supportive. Views were divided regarding hearing discussions around blood loss/airway before their procedure, supporting appropriate modifications to the tool. Patients did not feel they had a strong role to play in safety improvement more broadly.
  
  
  CONCLUSIONS
  It is feasible and instructive to capture patients' views of the delivery of safety improvements like the checklist. We have demonstrated strong support for the checklist in a sample of surgical patients, presenting a challenge to those resistant to its use.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Stephanie Jane
authors.initials: SJ
authors.lastname: Russ
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Rout
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Jochem
authors.initials: J
authors.lastname: Caris
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Krishna
authors.initials: K
authors.lastname: Moorthy
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Erik
authors.initials: E
authors.lastname: Mayer
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Vincent
mesh_terms: D000328:Adult; D000368:Aged; D057189:Checklist; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008875:Middle Aged; D009873:Operating Rooms / Q000592:standards*; D010348:Patient Care Team / Q000592:standards; D061214:Patient Safety / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards*; D013514:Surgical Procedures, Operative / Q000592:standards*; D011795:Surveys and Questionnaires; D014944:World Health Organization
keywords: Attitudes; Checklists; Patient safety; Quality improvement; Surgery