EDITIONEN·FR·ქართ

Accréditation Sans Frontières

International Accreditation of Healthcare Facilities

Standards › Standard 2 › Policies

Policy · SRG-POL-001 · Version 1.0 · Approved by the ASF Expert Committee

Supports: 2.1

At a glance

  • Every procedure has a surgical safety checklist, completed aloud by the team.
  • The checklist has three pauses: sign-in, time-out before incision, and sign-out.
  • Patient, procedure and body site are verified at the time-out.
  • The checklist is completed before the procedure, not written up afterwards.
  • Stop and get help straight away if: a procedure starts with no time-out, or the checklist is completed after the patient has left the theatre.

1. Purpose

To make sure the team confirms the right patient, the right procedure and the right site together, at each pause (2.1).

2. Scope

Applies to Clinical and support staff in the hospital
Locations All wards, clinics and departments of the facility
When Whenever the activity described is carried out
Does not apply to Activities covered by another document listed in section 15

3. Definitions

Term Meaning
Clinical lead The doctor or nurse in charge of the area at the time

4. Background

The surgical safety checklist works only when the team says it out loud, together, at each pause. A checklist filed after the operation protects no one.

5. Responsibilities

Role Responsibility Competence
Theatre manager Owns the checklist and audits it Management
Surgeon Leads the time-out Surgeon
Anaesthetist and nurse Read and confirm each item aloud Clinician

6. Materials and equipment

Item Requirement Condition
Records and forms named in this document Current version Checked before use

7. Safety

8. Before you start

9. Procedure

Step 1. Sign in.

  • Before induction, the anaesthetist and nurse confirm identity, site marking, allergies and equipment aloud (SRG-FRM-001).

Key point: Before anaesthesia, not after.

Step 2. Time-out.

  • Before incision, the whole team stops and says aloud: patient, procedure, site, antibiotics, critical events and imaging.
  • Nobody starts until everyone has spoken.

Key point: The team pause is the check.

Step 3. Sign out.

  • Before the patient leaves the theatre, the nurse reads out the instruments and swabs count, the specimens and any equipment problems.

Key point: Counts are read aloud.

10. Decision points

11. Special situations

Situation Action
Out of hours Follow the same steps. Use the on-call contact on the wall of the area.

12. Escalation

13. Monitoring

Measure Target Frequency Owner If not met
Procedures with checklist completed in all three pauses 100% Monthly Theatre manager Escalate to chief executive
Procedures with time-out before incision 100% Monthly Theatre manager Escalate to chief executive

14. Records

Record Kept in Retention
Record named in this document Patient record or the area file the period set by the facility’s records policy years

15. Training

16. Related documents

ID Title Use
SRG-SOP-001 Surgical safety checklist procedure Procedure
SRG-FRM-001 Surgical safety checklist record Record
ID-FRM-001 Patient identification check log Identity check

17. Evidence

Reference Note
E-009 ASF Expert Committee consensus. Based on the WHO Surgical Safety Checklist (2009).
E-006 ASF Policy Framework v1.2. Adapted.
E-009 ASF Expert Committee consensus.

18. Change history

Version Date What changed Approval
1.0 the date of approval First version set Expert Committee approval

E-learning for this document

No e-learning course is linked to this document yet.

References

Download this document as PDF
© 2026 Accréditation Sans Frontières · PHIG · Sheni Network