Effectiveness of Surgical Checklists in Reducing Errors: A Review-Based Approach

Background: Surgical safety checklists have been largely implemented as a measure to minimize avoidable errors and improve communication in operating theaters. Though used across the world, differences in implementation and results make it important to have a true evaluation of their overall impact. Objective: To determine the effect of surgical safety checklists on error reduction, teamwork communication, and challenges in implementation through a systematic review-based synthesis of high-quality systematic reviews. Methods: Narrative synthesis using data from eight systematic reviews obtained from databases such as PubMed and Cochrane Library was done. Reviews were chosen depending on relevance to surgical safety checklists, error reduction outcomes, and teamwork dynamics. Data were brought out and synthesized across three domains: clinical effectiveness, communication enhancement, and implementation challenges. The quality assessment was conducted using the AMSTAR 2 instrument. Results: Surgical checklists reduced wrong-site surgery, retained items, and surgical site infections consistently. Improvements in team communication reported varied between 55% and 88% in studies. Staff resistance, poor training, and interference with workflow were the main barriers to effective use. All this notwithstanding, the overall rating for effectiveness was best in error reduction (4.5/5) and improving teamwork (4.3/5), with moderate ratings for feasibility and sustainability. Conclusion: Surgical checklists can be effective approaches to improve patient safety and communication during intraoperative care with the right organizational support and consistent utilization. We have established that incorporating checklists within a culture of safety can enhance their use and sustainability in the long-term.