Introduction: Inter-professional teamwork-an important factor for patient safety. World Health Organization (WHO) introduced Surgical Safety Checklist which has shown to improve intraoperative teamwork and contribute to postsurgical safety culture by reducing surgical morbidity and mortality. Our aim is assessing the use of surgical safety checklist, its completion rate and attitude of operating room staff towards its use, barriers to implementation and methods to improve compliance. Methods: A prospective study was conducted In August 2018, a total of 262 surgeries were performed in the department of general surgery, accordingly surgeries were observed for briefing team and data collected regarding the completion of Surgical Safety Checklist (SSC). Post August questionnaires were given to operating room staff to ask their opinions regarding the checklist, beliefs and barriers. Results: Only 16.03% of the checklist were completely performed, while 55.72% remained partially complete and 28.2% were such that none of the components of checklists in the patient files were filled in; with more usage of checklist during elective procedures, 13.14% completely performed and 73.14% were partially complete. About 57.47% of checklist remained completely unused during emergency surgery. Overall, lack of briefing team was noted in >80% of time. More than 80% of people believed that usage of checklist reduces likelihood of human error and main barrier for lack of usage being lack of training and assertiveness. Conclusion: Appropriate utilization and compliance of Surgical Safety Checklist is dependent on the training of staff. It cannot be assumed that the introduction of a checklist will lead to improved outcomes unless followed. The functioning of checklist requires people to make one salient change particularly, the operating team has to pause during sign in (SI) time out (TO) and sign out (SO) phases before continuing as it just acts as a reminder at every stage of surgery. Actual usage of checklist has to be made rather than blindly filling in the box because compliance is important than the completeness of the checklist.

Keywords: Surgical safety checklist, Sign in, Time out, Sign out.