Global Research Project D-25:
A Multinational Audit of WHO Surgical Safety Checklist Adherence in Low-Resource Settings
Building the world’s largest multicountry evidence base on surgical safety checklist adherence in constrained environments to inform practice, training, and policy.
About the Study
This multicenter audit evaluates real‑world adherence to the WHO Surgical Safety Checklist (SSC) across diverse low‑resource settings. Using a standardized tool, sites record compliance during Briefing, Sign‑In, Time‑Out, Sign‑Out, and Debriefing, including obstetric variables for Cesarean sections such as fetal heart rate confirmation and neonatal equipment readiness.
- Design: multi‑country, prospective, observational audit; quota-based sampling per site permitted.
- Primary outcomes: phase-by-phase SSC adherence; association with perioperative events where available.
- Data handling: de‑identified at source; encrypted transfer and storage; aggregate reporting.
- Lead institution: The Operating Room Global (TORG). Project code: D‑25.
How Data Are Collected
- Local auditors complete the standardized Google Form for each eligible surgical case.
- Mandatory fields enforce completeness; obstetric items appear when Cesarean is selected.
- Entries are de‑identified at source; no patient identifiers are transferred.
- Weekly monitoring checks ensure quality and resolve queries.
After submission: entries cannot be edited to protect data integrity. Please review carefully before submitting each case.
Ethics & Governance
- Umbrella approval: TORG‑IRB/002/2025.
- Local IRB approval/exemption required at each site before data collection.
- Data Sharing Agreements (DSAs) executed with all institutions.
- No patient contact; minimal‑risk, observational audit; consent waiver requested as per policy.
A Huge THANK YOU to All Our Confirmed Institutions!
Your partnership is key to generating real-world evidence that can inform local and global surgical safety policies. We move together for safer surgery everywhere.
𝑴𝒐𝒏𝒕𝒉 5 𝑷𝒓𝒐𝒋𝒆𝒄𝒕 𝑼𝒑𝒅𝒂𝒕𝒆 – 𝑻𝑶𝑹𝑮 𝑮𝒍𝒐𝒃𝒂𝒍 𝑹𝒆𝒔𝒆𝒂𝒓𝒄𝒉 𝑷𝒓𝒐𝒋𝒆𝒄𝒕 𝑫-25
TORG Global Research Project D-25 – Month 5 Update: Multinational Audit of WHO Surgical Safety Checklist Adherence in Low-Resource Settings
As we conclude Month 5 of this multinational audit, we are proud to report:
735 patients enrolled and counting.
The latest data highlights our leading contributors:
Top 5 Countries
1. Ethiopia
2. Nigeria
3. Tanzania
4. Pakistan
5. Ghana
Top 10 Hospitals
1. Global Maternity, Tanzania
2. Debre Berhan Comprehensive Specialized Hospital, Ethiopia
3. University of Gondar Comprehensive Specialized Hospital (UOG), Ethiopia
4. Babcock University Teaching Hospital, Nigeria
5. Indus Hospital & Health Network (IHHN) QF, NST & SMP Campus, Pakistan
6. Federal Medical Centre Nguru, Nigeria
7. District Headquarter Hospital, Parachinar, Pakistan
8. Aminu Kano Teaching Hospital, Nigeria
9. FOCOS Orthopedic Hospital, Ghana
10. Debre Tabor Comprehensive Specialized Hospital, Ethiopia
With sustained participation across multiple countries and institutions, this project continues to demonstrate the strength of collaborative global research in advancing surgical safety in low-resource settings.
Our sincere appreciation goes to every investigator, site lead, and data collector contributing to this growing evidence base. Each submitted case strengthens our understanding of WHO Surgical Safety Checklist implementation and moves us closer to impactful, system-level recommendations.