In response to rising surgical errors, the Keralam government has issued a new surgical safety protocol aimed at enhancing patient safety within the state's healthcare system. The initiative, authorized by IAS officer Rajan Namdev Khobragade, aligns with World Health Organization guidelines and incorporates specific improvements tailored to Keralam. The protocol mandates all healthcare facilities, from primary health centres to tertiary institutions, to adopt standardized surgical safety practices. Key measures include the use of preoperative checklists, mandatory patient identity confirmations, and clear surgical site markings to prevent errors such as wrong-site surgeries. A three-stage verification process—Sign-In, Time-Out, and Sign-Out—ensures correct patient identification and surgical site confirmation. To combat issues like human error and miscommunication, the protocol emphasizes structured training, regular audits, and the establishment of Root Cause Analysis teams. The protocol also encourages a culture of safety through non-punitive reporting systems and accountability among healthcare teams. The Directors of Medical Education and Health Services are tasked with ensuring the prompt implementation of these guidelines across all institutions.