Best Practices for Surgical Safety in Orthopaedics: A Comprehensive Review of Checklist Implementation

Despite advances in surgical techniques and technology, surgical complications in orthopaedics remain a significant patient safety concern, with preventable major errors continuing to occur. The implementation of surgical safety checklists and time-out procedures has emerged as a critical intervention to enhance patient safety and reduce complications. This narrative review examines the role of surgical checklists and time-out procedures in reducing complications specific to orthopaedic surgery, analyzing their effectiveness, implementation challenges, and impact on patient outcomes. A comprehensive literature review was conducted examining peer-reviewed articles, systematic reviews, and clinical guidelines related to surgical safety checklists and time-out procedures in orthopaedic practice. Sources included studies on the available surgical safety checklist, never events data, and orthopaedic-specific safety interventions. Evidence demonstrates that structured surgical checklists and time-out procedures significantly reduce wrong-site surgery, retained foreign objects, and communication-related errors in orthopaedic practice. Applying surgical safety checklists in practice has shown effectiveness in reducing overall surgical complications and mortality. However, compliance rates vary significantly across institutions and countries. Surgical checklists and time-out procedures represent essential safety interventions in orthopaedic practice. While evidence supports their effectiveness in reducing complications and improving communication, successful implementation requires organizational commitment, staff education, and ongoing monitoring to ensure sustained compliance and optimal patient outcomes.