The Kerala Health Department has introduced a comprehensive surgical safety protocol to prevent medical errors during procedures, following alleged lapses in state-run hospitals that recently triggered a political controversy.
As per an official order dated April 15, the new guidelines mandate stringent pre-operative verification, accurate patient identification, and enhanced documentation to ensure safety across all healthcare institutions in Kerala.
Under the protocol, patients must wear wristbands containing complete surgical details, and the exact surgical site must be clearly marked in advance to eliminate the risk of wrong-site operations. To minimise distractions inside operation theatres (OTs), phone calls and non-essential communications have been restricted.
Doctors and nurses are required to complete all patient-related details, including inpatient (IP) numbers and case records, prior to surgery. A mandatory pre-operative checklist must be filled and signed by the ward doctor and nurse-in-charge, and subsequently verified by the OT nursing officer before the patient is shifted to the theatre.
The guidelines also emphasise strict counting and documentation of surgical instruments and materials. These details must be recorded on a whiteboard before the procedure and rechecked after completion, with reports submitted to the concerned authorities.
Highlighting patient involvement, the protocol calls for clear communication about procedures, risks, and benefits. Separate consent forms are required for anaesthesia, surgery, and blood transfusion. Hospitals have also been directed to strengthen counselling systems and ensure regular updates are provided to patients’ relatives.
To foster a “culture of safety,” institutions have been encouraged to promote error reporting without assigning blame, strengthen teamwork, and conduct periodic training sessions and mock drills for OT staff. Additional safeguards include measures to prevent retained foreign objects, equipment-related errors, and miscommunication, along with a mandatory root cause analysis of adverse events within 24 hours.
Officials noted that the protocol aligns with global safety standards, including those of the World Health Organization, while incorporating context-specific improvements.
Authorities have directed the Director of Medical Education and the Director of Health Services to ensure immediate implementation across all healthcare institutions. The move is aimed at reinforcing Kerala’s healthcare system—often regarded as a model for other states—by ensuring safer, standardised, and accountable surgical practices.
With PTI inputs