Patient Safety Tool: Ambulatory Surgery Surgical Checklist

SCOAP (Surgical Care and Outcomes Assessment Program), a program of the Foundation for Health Care Quality, provides a free, downloadable surgical checklist for ambulatory surgery.


The one-page checklist was adapted from the WHO "Safe Surgery Saves Lives" campaign and a surgical checklist developed by the Washington State Ambulatory Surgery Association and Proliance Surgeons.


It addresses what actions need to be taken during three steps: prior to incision, process control and debriefing (at completion of case).


Download the SCOAP ambulatory surgery surgical checklist (pdf) for adaptation and use in your facility.


Note: View our database providing 150 reports that link to free, downloadable and adaptable tools for use in surgery centers, hospitals and other organizations by clicking here.


Related Articles on Surgical Checklists:

ASCs Reminded to Use Safe Surgical Checklists Beginning Jan. 1

6 Steps to Prevent Wrong-Site Surgery

Study: Surgical Checklists Require Training to Achieve Surgeon, Anesthesiologist Compliance

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