In the Dec. 2010 addition of the Arkansas BlueCross BlueShield provider's news publication, BCBS provides an adopted version of the World Health Organization Surgical Safety Checklist.
Along with the adopted checklist, BCBS provides an entire "starter kit" to assist with implementation of the checklist, including guidance for how to implement it effectively, a worksheet to help ensure effective integration and clinical tips for the sign in, time out and sign out processes.
To review and download the starter kit, click here (pdf). The kit can be found on pp. 9-20.
Read about and download other surgical safety tools:
- Sample Sterile Processing Department Testing and Load Form and QI Worksheet
- Sample Annual Tuberculosis Risk Assessment Worksheet
- Sample Form for Documentation of Wound Infections