Ambulatory Surgery Center Safety Checklist [FREE PDF]
ASC administrators and OR managers use this checklist per CMS Ambulatory Surgical Center Conditions for Coverage (42 CFR 416) for surgical suite safety and patient care compliance.
- Industry: Healthcare / Surgery
- Frequency: Daily
- Estimated Time: 15-20 minutes
- Role: OR Manager / Administrator
- Total Items: 8
- Compliance: CMS 42 CFR 416, AAMI ST79 Sterilization
OR Suite Readiness
Verify operating room readiness and sterile processing.
- Are sterilization biological indicators (spore tests) passing with results documented?
- Is surgical equipment checked, calibrated, and ready for the day's cases?
- Is the malignant hyperthermia cart stocked and emergency transfer agreement current?
- OR readiness notes
Patient Safety & Surgical Checklist
Verify patient safety checks and surgical time-out.
- Is the surgical time-out conducted per WHO/Joint Commission Universal Protocol?
- Are informed consent and site marking verified before every procedure?
- Are discharge criteria (Aldrete score) met before patient release?
- Patient safety notes
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Why Use This Ambulatory Surgery Center Safety Checklist [FREE PDF]?
This ambulatory surgery center safety checklist [free pdf] helps healthcare / surgery teams maintain compliance and operational excellence. Designed for or manager / administrator professionals, this checklist covers 8 critical inspection points across 2 sections. Recommended frequency: daily.
Ensures compliance with CMS 42 CFR 416, AAMI ST79 Sterilization. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Ambulatory Surgery Center Safety Checklist [FREE PDF] cover?
This checklist covers 8 inspection items across 2 sections: OR Suite Readiness, Patient Safety & Surgical Checklist. It is designed for healthcare / surgery operations and compliance.
How often should this checklist be completed?
This checklist should be completed daily. Each completion takes approximately 15-20 minutes.
Who should use this Ambulatory Surgery Center Safety Checklist [FREE PDF]?
This checklist is designed for OR Manager / Administrator professionals in the healthcare / surgery industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.