J Clin Res Gov 2 (2013) 53-56 53 Swedish Science Pioneers Developing World Journal Series Journal of Clinical Research & Governance www.jcrg.sciencepub.se Research Article Opinions of Anesthesiologists and Surgeons about World Health Organization Surgical Safety Checklist in a Tertiary hospital in Iran, 2012 Mahasti Alizadeh a , Hossein Jabbari Bayrami a , Maryam Baradaran a , Reza Movassaghi Gargari b , Ramin Azhough c a: Community Medicine Department, Tabriz University of Medical Sciences, Tabriz, Iran b: Department of Anesthesiology ,Imam Reza Hospital. Tabriz University of Medical Sciences, Tabriz, Iran c: Department of General Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran Correspondence Maryam Baradaran Department of Community Medicine Faculty of medicine Tabriz University of Medical Sciences Tabriz, Iran Postal code: 5166614766 Tell: +98-411-3364673 Email:maryam_baradaran@hotmail.com Keywords: Patient Safety Operating Rooms Surgical Safety Checklist Hospital Infection Hospital Mortality Received: 2013-06-15 Accepted: 2013-07-29 Abstract Purpose: The aim of this study was determine the opinions of clinicians in order to modify the surgical safety checklist(SSC) to make it compatible for use in hospitalsof Iran. Methods:In a cross-sectional study, the views of surgeons and anesthesiologists of the main teaching hospital in Tabriz -Imam Reza Hospital- were taken by a form attached to the main checklist. The participants in this study were asked to write their opinions on each item of the checklist based on the environment of the hospital. The opinions were classified and analyzed. Results:Most of the anesthesiologists(87.5%) and some of the surgeons (18%)recommended to change the fourth item of sign-in part. They suggested using vital sign and base monitoring instead of pulse oximetry. Three of the physicians added the "Internal Medicine Consultation" and "output monitoring" to the Critical Events Anticipation item. Hemorrhage, vomiting, nausea, and hemodynamic disorders were added to the key concerns of recovery and management item by 75% of anesthesiologists. Conclusion:It is better to modify the Surgical Safety Checklist based on the local needs and facilities of each hospital. Surgeons and anesthesiologists in an Iranian teaching hospital suggested adding some items to each part of SSC. DOI: 10.13183/jcrg.v2i2.58 © 2013 Swedish Science Pioneers, All rights reserved. Introduction Overload of major surgeries has significant implications for public health. Since the case mix is so different, the rates of death and complications after surgery are difficult to be compared. In industrialized countries, the rate of major complications has been occurred in 3–22% of inpatient surgical procedures, and the death rate is about 0.4 - 0.8% [1]. Approximately, half of the adverse events in these studies were avoidable. Studies in developing countries suggest a death rate of 5–10% occurring in major surgeries. Infections and other postoperative complications are also a serious concern worldwide [1-9]. Despite high improvements in the knowledge of safety in surgery, at least half of the adverse events occur during surgical care. Nearly seven million patients suffer from significant surgical complications each year, one million of whom die during or immediately after surgery .Accordingly, Surgical safety has emerged as a major global public health concern [1]. In May 2004, the world health organization (WHO) approved the creation of an alliance to improve patient safety globally; WHO Patient Safety was launched the following in October. For the first time, heads of agencies, policy-makers and patient groups from all over the world gathered together to improve the accomplishment of the goal of “First, do no harm” and to reduce the adverse events of unsafe health care. The goal of WHO Patient Safety is to help patient safety policy and practice. Designing tools for improvement of patient safety including surgical safety checklist was one of their actions. These efforts could save millions of lives by improving basic health care [4]. The Checklist should be modified to account for differences among hospitals according to their processes and the culture of their operating. Modification of the Checklist should be done critically. Surgeons, anesthesiologists, and nurses should be involved in the modification process [9]. Tabriz Imam Reza hospital is a referral and the largest specialty and subspecialty hospital in Northwest of Iran. Considering WHO surgical safety checklist advantages and importance of clinical governance which patients safety is one of its key components, we decided to modify WHO surgical safety checklist to fit with Tabriz Imam