The WHO surgical safety checklist was introduced at Derriford Hospital in 2009. Evidence of the effect on efficiency has been slow to appear in the literature.

Using a standardised, locally modified WHO surgical safety checklist theatre list capacity, start and finish times as well as time between cases was measured in 4 elective orthopaedic theatres. Data from 3 successive years was analysed retrospectively: prior to checklist introduction, during checklist introduction and routine checklist use.

Data was analysed using the One-Way ANOVA with post-hoc Tukey test. The number of cases per list showed a statistical difference from Year 1–2 and this increase was sustained in Year 3. The number of delayed starts showed no difference between Year 1&2, followed by a statistically significant decrease in Year 3. The number of late finishes showed a statistical difference from Year 1–2 and this decrease was sustained in Year 3. However, the number of lost minutes between cases showed no difference between Year 1&2, followed by an increase in Year 3.

This study demonstrates that pre-list briefings combined with the WHO surgical checklist can improve theatre list capacity and prompt starts, reduce the number of overruns, however fails to improve turnaround time between cases.