Reimplementing a comprehensive safety checklist intervention significantly improved team behavior, safety culture, patient safety, and patient outcomes, according to a study published in JAMA Surgery. James C. Etheridge, MD, MPH, and colleagues explained that underperforming surgical checklists require evidence-based reimplementation guidelines to maximize patient safety. To assess the impact of reimplementing a comprehensive safety checklist system, they conducted a prospective type 2 hybrid implementation-effectiveness study, including 252 cases, 161 at baseline, and 91 at the study endpoint. They used the Oxford Non-Technical Skills (NOTECHS) system to evaluate team performance. Checklist penetration rates were positive at both time points, and the researchers found significant improvements in all fidelity measures after reimplementation. Mean NOTECHS scores increased from 37.1 to 42.4 points (4.3-point adjusted increase; 95% CI, 2.9-5.7; P<0.001), mean device-related interruptions decreased by 86.5% (95% CI, -22.1% to -97.8%; P=0.03), and 9 of 12 composite areas on culture of safety surveys improved. An exploratory analysis of the data showed reductions in patient safety events, mortality, and serious complications.