The World Health Organization’s surgical safety checklist (WHO SSC) is designed to improve adherence to operating room safety standards. Its use has been shown to reduce surgical morbidity and mortality. Studies on solely neurosurgical patients have been sparse.

The aim of this study was to evaluate the impact of the implementation of the checklist on safety-related issues in the OR and patient outcomes in neurosurgical patients. Safety-related issues in the operating room were assessed based on data collected through a personnel questionnaire. Electronic hospital and patient records were utilised to survey postoperative adverse events before and after the checklist implementation. The hypothesis was that implementing the checklist would enhance safety attitudes in the OR and reduce postoperative adverse events.

The checklist implementation enhances safety-related performance in the OR. Postoperative wound complications and unplanned readmissions were observed to reduce significantly. Data obtained from the hospital-acquired infection register revealed a reduction in early-on surgical site infections, although the overall surgical site infection rate did not decrease. Use of the WHO SSC was associated with reduced the rate of complication-related reoperations, especially preventable infections leading to reoperation. A separate literature review on checklists in neurosurgery also found checklist use to reduce complications and enhance OR safety culture. However, the volume of studies on solely neurosurgical patients is small.

The use of the WHO SSC seems to improve patient safety in neurosurgery through enhanced communication and reduced adverse events, although the amount of evidence is still limited. In the future, technological advancements will raise a requirement to reconsider the contents of checklists.