Redesign a local surgical checklist workflow so sign-in, time-out and sign-out force a genuine team pause.
Healthcare & Pharmaceutical Management
Surgical Safety Checklist Compliance and Crew Resource Management
Move surgical teams beyond box-ticking on the WHO checklist by embedding crew resource management habits that make sign-in, time-out and sign-out genuinely reduce harm.
🗓️Duration5 training days
📚Content4 modules · 8 sessions
🎓On completionAccredited attendance certificate
About the programme
Course Overview
Most operating theatres run the WHO Surgical Safety Checklist, yet audits repeatedly find teams reciting it from memory while multitasking, which defeats its purpose. This course tackles that gap directly: it treats the checklist not as a form to complete but as a structured communication event, and pairs it with crew resource management techniques borrowed from aviation to change how surgical teams actually talk to each other. Participants examine why checklist fatigue sets in, how to redesign local checklist workflow to force genuine pauses at sign-in, time-out and sign-out, and how to run direct observation audits that distinguish real compliance from box-ticking. The crew resource management modules cover structured pre-list briefings, situational awareness monitoring, closed-loop communication and graded assertiveness techniques that let junior staff challenge a senior surgeon safely. Simulation-based exercises let participants rehearse a time-out interruption, a near-miss escalation and a post-case debrief. Graduates leave able to audit compliance credibly, redesign a checklist workflow for their own theatre, and coach a team toward a genuine speak-up culture rather than a symbolic one.
Expected Learning Outcomes
Conduct a direct observation audit that distinguishes authentic checklist compliance from recitation by memory.
Run a structured pre-list briefing that surfaces case-specific risks before the first incision.
Apply closed-loop communication technique to confirm critical instructions during a simulated surgical scenario.
Coach graded assertiveness so junior team members can escalate a safety concern to a senior surgeon.
Design a post-case debrief format that captures lessons without assigning blame to individual staff.
Present theatre-level compliance data to leadership with a credible improvement plan attached.
Who Should Attend
Theatre managers and perioperative nurse leaders overseeing checklist compliance
Surgeons and anaesthetists wanting to strengthen team communication in theatre
Patient safety officers auditing surgical checklist adherence across departments
Simulation centre educators designing crew resource management training
Clinical governance staff investigating theatre-related adverse events
Scrub and circulating nurses taking on checklist coordination responsibilities
Course Modules
Select any module to see its sessions and points.
01WHO Surgical Safety Checklist Design and Embedding
2 sessions · 8 points
Session 1Checklist Structure and the Three Phases
- Map the sign-in, time-out and sign-out phases to the specific risks each is designed to catch.
- Adapt the standard checklist wording to local case mix without dropping safety-critical items.
- Assign clear ownership of each checklist item to a named team role rather than 'whoever is free'.
- Identify common omissions, such as skipped allergy checks or instrument counts, in routine theatre practice.
Session 2Overcoming Checklist Fatigue and Box-Ticking
- Diagnose the causes of checklist fatigue in high-volume theatres running back-to-back lists.
- Redesign checklist delivery so it interrupts ongoing tasks rather than competing with them.
- Rotate the reading role among team members to prevent complacent, monotone recitation.
- Introduce case-specific prompts that make each time-out feel relevant rather than generic.
02Measuring and Auditing Compliance
2 sessions · 8 points
Session 1Direct Observation and Compliance Auditing Methods
- Design a direct observation audit tool that scores engagement, not just verbal completion of items.
- Train auditors to recognise silent nodding and inattentive recitation as non-compliance indicators.
- Sample audits across shifts, specialties and seniority levels to avoid a biased compliance picture.
- Calculate compliance rates and benchmark them against comparable theatre suites or national data.
Session 2Using Compliance Data to Drive Behaviour Change
- Feed back audit results to individual surgical teams in a way that invites improvement rather than defensiveness.
- Link recurring non-compliance patterns to specific redesign actions rather than repeated reminders.
- Track compliance trends alongside surgical site infection and wrong-site event rates over time.
- Report checklist compliance metrics to governance committees as part of routine safety dashboards.
03Crew Resource Management Principles in the Operating Theatre
2 sessions · 8 points
Session 1Briefing, Debriefing and Situational Awareness
- Structure a pre-list team briefing covering case order, anticipated risks and equipment needs.
- Apply situational awareness monitoring to detect when a team is losing shared understanding mid-case.
- Recognise early warning signs of task fixation and workload overload in individual team members.
- Facilitate a structured post-case debrief that closes the loop on issues raised during the briefing.
Session 2Closed-Loop Communication and Graded Assertiveness
- Apply closed-loop communication so every instruction is acknowledged and confirmed before action is taken.
- Teach a graded assertiveness ladder that escalates concern from a question to a direct statement.
- Practise a scripted challenge phrase that any team member can use to pause a procedure safely.
- Debrief a simulated scenario in which a junior team member successfully halts an unsafe step.
04Embedding Teamwork Through Simulation and Culture Change
2 sessions · 8 points
Session 1Simulation-Based CRM Training Design
- Design a simulation scenario that forces a checklist interruption and a team communication failure.
- Select simulation modality, from low-fidelity tabletop exercises to full-scale mock theatre runs.
- Facilitate a structured debrief using a recognised model that separates observation from judgement.
- Evaluate simulation outcomes against defined teamwork behaviours rather than technical skill alone.
Session 2Sustaining a Speak-Up Culture Across Surgical Teams
- Identify hierarchy-related barriers that discourage staff from raising concerns in the operating theatre.
- Design leadership rounding practices that reinforce speak-up behaviour in day-to-day theatre work.
- Recognise and publicly reinforce examples of successful assertive intervention by junior staff.
- Plan a sustainability strategy that keeps crew resource management habits active after initial training ends.
What the participant receives
4 course modules
A structured syllabus
8 training sessions
across 5 days
32 detailed points
Applied, detailed content
Accredited attendance certificate
On completing the programme
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