• Anette Storesund, Arvid Steinar Haugen, Hilde Valen Wæhle, Rupavathana Mahesparan, Marja A Boermeester, Monica Wammen Nortvedt, and Eirik Søfteland.
• Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
• BMJ Open Qual. 2019 Jan 1; 8 (1): e000488.

IntroductionSurgical safety checklists may contribute to reduction of complications and mortality. The WHO's Surgical Safety Checklist (WHO SSC) could prevent incidents in operating theatres, but errors also occur before and after surgery. The SURgical PAtient Safety System (SURPASS) is designed to intercept errors with use of checklists throughout the surgical pathway.ObjectiveWe aimed to validate a Norwegian version of the SURPASS' preoperative and postoperative checklists for use in combination with the already established Sign In, Time Out and Sign Out parts of the WHO SSC.Methods And MaterialsThe validation of the SURPASS checklists content followed WHOs recommended guidelines. The process consisted of six steps: forward translation; testing the content; focus groups; expert panels; back translation; and approval of the final version. Qualitative content analysis was used to identify codes and categories for adaption of the SURPASS checklist items throughout Norwegian surgical care. Content validity index (CVI) was used by expert panels to score the relevance of each checklist item. The study was carried out in a neurosurgical ward in a large tertiary teaching hospital in Norway.ResultsTesting the preoperative and postoperative SURPASS checklists was performed in 29 neurosurgical procedures. This involved all professional groups in the entire surgical patient care pathway. Eight clinical focus groups revealed two main categories: 'Adapt the wording to fit clinical practice' and 'The checklist items challenge existing workflow'. Interprofessional scoring of the content validity of the checklists reached >80% for all the SURPASS checklists.ConclusionsThe first version of the SURPASS checklists combined with the WHO SSC was validated for use in Norwegian surgical care with face validity confirmed and CVI >0.80%.Trial Registration NumberNCT01872195.

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