title: Compliance and Effectiveness of WHO Surgical Safety Check list: A JPMC Audit.
abstract: OBJECTIVE
  To assess World Health Organization (WHO) Surgical Safety Checklist (SSC), compliance and its effectiveness in reducing complications and final outcome of patients.
  
  
  METHODS
  This was a prospective study done in Department of General Surgery (Ward 02), Jinnah Postgraduate Medical Centre (JPMC), Karachi. The study included Total 3638 patients who underwent surgical procedure in elective theatre in four years from November 2011 to October 2015 since the SSC was included as part of history sheets in ward. Files were checked to confirm the compliance with regards to filling the three stage checklist properly and complications were noted.
  
  
  RESULTS
  In 1st year, out of 840 surgical procedures, SSC was properly marked in 172 (20.4%) cases. In 2nd year, out of 857 surgical procedures 303 (35.3%) cases were marked which increased in 3rd year out of 935 surgical procedures 757 (80.9%) cases and in 4th year out of 932 surgical procedures 838 (89.9%) cases were marked. No significant change in site and side (left or right) complications were noted in all four years. Surgical Site Infection (SSI) was noted in 59 (7.50%), 52 (6.47%), 44 (4.70%) and 20 (2.12%) cases in 1st, 2nd, 3rd and 4th year respectively. SSI in laparoscopic cholecystectomies was 41 (20.8 %), 45 (13%), 20 (5.68%) and 4 (1.12%) in 1st, 2nd, 3rd and 4th year respectively. No significant change in chest complications were noted in all four years. Mortality rate also remained same in all four years.
  
  
  CONCLUSIONS
  WHO SSC is an effective tool in reducing in-hospital complications thus producing a favorable outcome. Realization its efficacy would improve compliance.
authors.affiliation: Dr. Mariyah Anwer, Senior Registrar, Ward 2, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
authors.forename: Mariyah
authors.initials: M
authors.lastname: Anwer
authors.affiliation: Dr. Shahneela Manzoor, Postgraduate Trainee, Ward 2, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
authors.forename: Shahneela
authors.initials: S
authors.lastname: Manzoor
authors.affiliation: Dr. Nadeem Muneer, Incharge, Department of Anesthesia, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Muneer
authors.affiliation: Prof. Shamim Qureshi, Head of the Department, Ward 2, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
authors.forename: Shamim
authors.initials: S
authors.lastname: Qureshi
keywords: Safe Surgery Saves Lives initiative; WHO Surgical safety checklist