Acta Chir Belg
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It is unclear which items of the WHO surgical safety checklist are most -crucial for producing its associated benefits. Thoughtless modification, especially removing items, can therefore potentially lead to reduced effectiveness of the instrument. This study describes the modifications made by Belgian hospitals. ⋯ The modifications made to the WHO checklist vary between hospitals. Only a small number of hospitals included all 22 WHO items. It is unknown whether these modified checklists will be equally effective in decreasing the number of postoperative complications, including mortality. More detailed recommendations and guidance regarding the modification of the WHO surgical checklist is required.