Hosptial Wing

Theatre Complex

Which Theatre

Which theatre?

Which Lab?

Theatre Complex

Which theatre?

Which theatre?

Which theatre?

Which theatre?

Which Specialty is the operating list?

How would you describe this list

Who is the named Consultant for this List/Case?

Briefing, Team & Location

What time did the Theatre Briefing begin?

Where was the Theatre Briefing conducted? ie. anaesthetic room, corridor etc

Please select the staff/personnel present at briefing

Consultant Surgeon

Surgical Registrar

Consultant Anaesthetist

Anaesthetic Registrar

Anaesthetic Practitioner (ODP/Nurse)

Surgical Scrub Lead Practitioner (Nurse/ODP)

How many Scrub/Circulating staff are present (including Scrub Lead)?

Are there other personnel present?




Add a photo of briefing, team and location

Theatre Briefing

Planned Surgical Procedure for all patients discussed?

Please Comment

Order of the list confirmed/discussed

What is the reason?

Have all patients been seen by the anaesthetist?

Please comment

Has equipment (including prosthesis & monitoring) been discussed and available

Have any issues been identified?

Have any post-operative requirements or special investigations been raised for any of the patients?

Please comment

If there has been any equipment, post-op, patient, staffing or environmental issues raised, a named team member should be allocated to follow up & escalate their concerns.

On a scale of 1 - 10 how would you rank the briefing on quality and effectiveness? (1 Low -10 High)
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.