Abstract: There are provided systems and methods for ensuring compliance with mandated pre-operative policies and procedures to prevent wrong site surgeries. In an embodiment, at least two operating room personnel perform a pre-operative assessment prior to a scheduled surgical procedure. The at least two participants to the pre-operative assessment provide some indicia of their personal identity as a form of attestation to their respective participation in the pre-operative assessment. Upon verifying the submitted indicia of personal identification information received from each of the at least two operating room personnel participants to the assessment, critical operating room lighting fixtures and critical outlets are switched from an initialized disabled state to an enabled state to permit activation by the operating room personnel to allow the procedure to run its normal course. In another embodiment, a recording device is activated prior to the start of a pre-operative assessment.