Minnesota Hospital Association

Quality & Patient Safety

Surgery and procedures

In the years following the implementation of the adverse health event reporting law, wrong-site surgery and procedures (the wrong procedure being performed, or a procedure being performed on the wrong body part or patient) were on the rise.

An analysis of the data and root cause analyses showed that these events were primarily a breakdown in following basic best practices. In response, in 2007, Minnesota Hospital Association initiated the Call to Action framework for SAFE SITE. Like MHA’s other Calls to Action, it provides a road map of best clinical practices and a tool kit to implement the road map recommendations. The SAFE SITE road map builds on the Institute for Clinical Systems Improvement (ICSI) Safe Site Surgical Protocol. The initial efforts were focused on the operating room, but have expanded to include anesthesia, radiology, CV lab, endoscopy, bedside procedures, the emergency department, clinic settings and radiation therapy.

Download the Surgery road map.

SAFE Site toolkit

Hospitals can use these tools to implement the road map recommendations in their facilities. Hospitals may copy, translate, distribute and present the following SAFE SITE Toolkit items as long as you reference the Minnesota Hospital Association as the source of this material. If the tool is hospital-specific, please also cite the hospital as a source. Dates listed refer to the date the tool was posted on the website. Product examples within this tool kit are not inclusive nor intended as endorsement of a specific product. 

Safe site team

Access to information

Facility expectations

Educate staff and parents

Sign site with initials

Informed consent and verification


Effective communication

Data submission

MHA Quality and Patient Safety Data Portal

Requirements of SAFE SITE initiative participants:

  • Completion of baseline road map data submission and quarterly updates
  • Implementation of the SAFE SITE road map components
  • Share learnings with others through conference calls, listserv and other sharing opportunities.