Mobilising or standing still? A narrative review of Surgical Safety Checklist knowledge as developed in 25 highly cited papers from 2009 to 2016

Abstract

The Surgical Safety Checklist (SSC) was implemented as part of the World Health Organization’s Safer Surgery saves lives campaign. The SSC and its reported positive influence in the operating room was first published in 2008. Since then, this positive perception has changed. New research has identified mixed results showing limited or no change in outcomes following SSC implementation. Such research has prompted calls for the reconsideration of policies mandating the SSC as an organisational safety practice. In the context of this debate, the purpose of this narrative review was to evaluate how knowledge about SSC has been represented and reconstructed in high impact SSC papers. We used the h-index to identify highly impactful articles published between 2009 and 2016. We analysed these articles using three criteria that emerged as we reviewed them: 1) Whether the SSC was conceptualized as a ‘thing’ or a ‘process’, 2) Whether the SSC problem and solution were characterized as straightforward or complex issues and, 3) How the SSC knowledge was reconstructed from one paper to the next. We found that many papers in the sample exhibited a pattern of simplifying the story of SSC from earlier work, even when that work may itself have discussed a more nuanced characterization of SSC. This simplicity suggests that knowledge has not been mobilizing effectively across this body of work. We conclude that knowledge mobilization would be improved with a new generation of SSC research that particularly explores and enhances our understanding of the socio-cultural nuances of SSC practices.