Scaling Safety: The South Carolina Surgical Safety Checklist Experience.

Journal Article (Journal Article)

Proven patient safety solutions such as the World Health Organization's Surgical Safety Checklist are challenging to implement at scale. A voluntary initiative was launched in South Carolina hospitals in 2010 to encourage use of the checklist in all operating rooms. Hospitals that reported completing implementation of the checklist in their operating rooms by 2017 had significantly higher levels of CEO and physician participation and engaged more in higher-touch activities such as in-person meetings and teamwork skills trainings than comparison hospitals did. Based on our experience and the participation data collected, we suggest three considerations for hospital, hospital association, state, and national policy makers: Successful programs must be designed to engage all stakeholders (CEOs, physicians, nurses, surgical technologists, and others); offering a variety of program activities-both lower-touch and higher-touch-over the duration of the program allows more hospital and individual participation; and change takes time and resources.

Full Text

Duke Authors

Cited Authors

  • Berry, WR; Edmondson, L; Gibbons, LR; Childers, AK; Haynes, AB; Foster, R; Singer, SJ; Gawande, AA

Published Date

  • November 2018

Published In

Volume / Issue

  • 37 / 11

Start / End Page

  • 1779 - 1786

PubMed ID

  • 30395507

Electronic International Standard Serial Number (EISSN)

  • 1544-5208

Digital Object Identifier (DOI)

  • 10.1377/hlthaff.2018.0717


  • eng

Conference Location

  • United States