Because the investigators were leading the timeouts as part of a research study, adherence to all of the checklist items was reportedly 100%. By excluding the part of the timeout when the nurses address their checklist items (eg, instruments are sterile,) followed by a final opportunity as the timeout ends to note any errors or concerns, the study may have underestimated the rate of error reporting. Because the study did not query team members individually after the timeout, we also do not know how many errors were detected but not annunciated. ...recognised errors that were attributed to ‘misspeaking’ and/or had no clinical significance may not have been verbally challenged. ...as is discussed by the authors, there was an unequivocal hierarchy effect—individuals with the least ‘power’ (ie, low in hierarchy within the current healthcare culture) were the least likely to report the error. ...how can we best design and implement checklists and other safety interventions to yield more consistent and sustained clinician behaviour change?