Publicly Reported Patient Safety Indicator - Safe Surgery Check List

On October 1st 2009, the Ontario Ministry of Health and Long Term Care announced an additional publicly reported Patient Safety Indicator. Effective July 2010, all hospitals with Operating Rooms were required to use a documentation tool referred to as "The Safe Surgery Checklist". The Ministry captures the compliance rate of the use of this tool at each facility and reports that rate on its website. PRH displays its rate on the PRH website where other patient safety indicators are posted.

The percentage compliance is calculated as

#of times all three phases of the safe surgery checklist was performed x 100

Total Surgeries

Safe Surgery Check List Rate

January to March 2024 - 100% 


The tool and its use are based on researched best practice guidelines. It includes a series of questions and checkpoints the Surgical Team will review and sign off prior to commencing your procedure and again after the surgery is complete. It is comprised of 26 important patient safety processes/items that surgical teams should discuss at three critical points, with all team members present:

  1. The Briefing Phase: On arrival of the patient to the Operating Room and prior to anesthesia.
  2. The Time Out Phase: Immediately prior to commencement of the procedure.
  3. The Debriefing Phase: Immediately following the completion of the procedure.

Goals of the Surgical Safety Checklist:

  • Improving teamwork and communication.
  • Clarifying the minimum expected steps.
  • Ensuring adherence to evidence-based standards of care.

Why Use a Checklist?

Patient Safety remains the most important priority for PRH and this involves ensuring a safe experience for patients undergoing surgery here. Our patients can expect safe, high quality care and as such this tool will help to ensure a positive experience.

The health care industry has learned from other industries, which share elements of risk. Routine processes and practices in operating rooms can vary significantly from one surgery to the next and from one operating room to another. The development of practice guidelines and checklists helps standardize the care for patients and reduces the chance of errors by prompting teams to share critical information in the same way for every surgery.

Well Designed Checklists Incorporate:

  • Less reliance on memory.
  • Standardization of processes.
  • Access to information and feedback.
  • Reduction of avoidable complications and errors.
  • Confirmation that equipment is available.
  • That everyone is aware of how the procedure is expected to proceed.

The Value of Prompts and Reminders

The premise of the Surgical Safety Checklist is that no single professional can bear full responsibility for remembering the many steps required to reduce every preventable complication possible in a surgery. By helping the Surgical Teams take a consistent, standardized approach to every surgery, the Surgical Safety Checklist decreases reliance on memory and reminds team members of all the steps required prior to surgery. This is very similar to an airline checklist that pilots use in the cockpit prior to takeoff.

The structured prompts will benefit all surgical patients by helping to ensure all appropriate vital interventions are delivered consistently. Though there may always be some inconsistency in the delivery of evidence-based standards of care, the Surgical Safety Checklist can make it easier for teams to follow best practice by providing reminders at the right point in time in the surgical process.

The Checklist and Accountability

As patients, you place your trust in surgical care teams and give consent to allow them to participate in your care. In turn patients can expect to be told about the risks and benefits associated with health care and deserve a high degree of transparency and information about their care.

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