Use of the surgical safety checklist has been linked to improved patient outcomes, but checklist compliance has been variable. In this prospective trial, operating rooms (ORs) were equipped with remote video auditing and then cluster-randomized to either receive, or not receive, real-time feedback. Sign-in, timeout, and signout rates improved dramatically in both groups compared to the low baseline rates. ORs that received real-time feedback had significantly higher compliance scores than those that just had video recordings. Following this study period, all ORs received real-time feedback, resulting in pass rates up to 91% for sign-in, 95% for timeout, and 84% for signout. Mean turnover times for scheduled cases decreased with feedback, indicating enhanced efficiency. An accompanying editorial calls implementing videos with feedback the "next great leap forward" for patient safety. A recent PSNet perspective discussed the benefits of using video in clinical and educational settings.