Measuring variation in use of the WHO surgical safety checklist in the operating room: a multicenter prospective cross-sectional study.
Russ S, Rout S, Caris J, et al. J Am Coll Surg. 2015;220:1-11.
This direct observation study used a standardized protocol to assess the implementation of the safe surgery checklist and found wide variation in actual use of the tool. Challenges with implementation are thought to explain varying efficacy of checklists in clinical practice, in contrast to dramatic reductions in surgical mortality and complications in clinical trials.
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