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SAFE OR Programme

Hands all in, a group stands with their hands all piled on top of one another as an all in motion to support one another 

"Surgery is a critical component of healthcare and it is essential that surgical teams make their procedures safe and error proof."

The SAFE OR (Safe Operating Room) Programme is a short course for operating room professionals which focuses on teamwork in surgery.

Successful surgical outcomes depend not only upon the skills of the surgeon but also the health professionals who make up the wider surgical team. Anaesthetists, theatre nurses, operating department practitioners, obstetricians and recovery nurses all play their part in achieving a successful operation for the patient. Individual knowledge, competence and skills are important but individuals do not work in isolation. Effective teamwork is essential. 

SAFE OR is a multidisciplinary programme developed by a partnership between the Royal College of Surgeons of England, the Association of Anaesthetists, the Association for Perioperative Practice, Lifebox Foundation, the Royal College of Obstetricians and Gynaecologists and the World Federation of Societies of Anaesthesiologists. 

The programme aims to improve patient safety and surgical care through strengthened multidisciplinary teamwork, effective communication, cooperation and implementation of the W.H.O Surgical Safety Checklist. Programme sessions address the pre-, intra- and postoperative elements of providing safe surgery by exploring themes and techniques for good communication skills and working as a team, which are interwoven and reinforced throughout. It is both flexible (it can be held over one, two or three days) and is adaptable to local contexts and needs. The programme is always delivered to multidisciplinary surgical teams or groups of participants by a multidisciplinary faculty and represents one of a very few learning and skill acquisition programmes that has been developed and delivered this way. 

Programme format

Working in small groups, participants will complete a series of exercises, critical clinical scenarios and role-plays designed to improve their skills in communications, teamwork, handovers, issue identification and problem solving. Participants will also learn how to improve their working environment through quality improvement. 

Who should attend

This programme is suitable for everyone involved as a part of surgical teams - surgeons, anaesthetists, nurses, gynaecologists and operating department practitioners. It provides healthcare professionals with an opportunity to acquire, refresh and develop their interactive and interpersonal skills with other members of the surgical team. 

Faculty Development

The delivery model of SAFE OR includes a 'Training the Trainer' component to ensure sustainability, by developing local training capacity. 


W.H.O Surgical Safety Checklist

Leadership and communication

Leadership and teamwork

Communication skills

Situation awareness

Decision making

Critical scenarios (Part II)

Intraoperative cardiac arrest: effective resuscitation

Management of major haemorrhage

Polytrauma surgery

High spinal

WHO Checklist and related topics

Common errors in the OR

The team brief

Consent and checking the patient

WHO Checklist in action

Improving recovery after surgery

Postoperative pain management

Recovery from anaesthesia

Fluid management in the perioperative period

Postoperative instructions and handover

General safety and infection prevention

Conflict resolution in the OR

The sterile environment and antibiotics

Counting swabs, needles and instruments

Decontamination, reprocessing and care of surgical instruments and equipment in the OR

Audit and quality improvement

Morbidity and mortality meetings


Quality improvement

Critical scenarios (Part I)

Difficult intubation

Safe handling of blood

Time-critical obstetric emergencies

Time-critical surgical emergencies

Local anaesthetic toxicity

Faculty development

How to run a SAFE OR programme

Equipment list for SAFE OR

Adapting SAFE OR for local delivery

Alternative one, two and three day SAFE OR programme overviews


The next single day UK course is being held at the Royal College of Surgeons, Lincolns Inn Fields, LondonFriday 7 June

Register your interest for SAFE OR.




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