Abstract
BACKGROUND: Surgical care is an integral part of healthcare aimed at preventing surgical complications. To ensure safety during surgical procedures, the World Health Organization (WHO) introduced a surgical safety checklist (SSC). This checklist has been shown to significantly reduce the risk of complications and adverse outcomes caused by poor practices or negligence during surgeries. Methodology: Following ethical approval, an audit was conducted on 200 major surgeries performed at Fatima Memorial Hospital in Lahore. The WHO SSC was converted into a "Yes/No" questionnaire using Google Forms. The audit was conducted over two months, from July to August 2024. Compliance with the three checklist phases (Sign In, Time Out, and Sign Out) was analyzed using the IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, United States). Results: The Sign Out phase showed the highest compliance (178, 89%), followed by the Sign In phase (164, 82%). The lowest compliance was observed in the Time Out phase. Full compliance (100%) was recorded for obtaining patient consent, following anesthesia protocols, ensuring instrument sterilization, and team member introductions, indicating a safe and collaborative surgical environment. CONCLUSION: Overall, checklist compliance was satisfactory but could be improved through targeted awareness initiatives. While the study did not assess surgical outcomes directly, it highlighted risks associated with incomplete adherence to the WHO checklist.