![]() ![]() A designated member of the team starts the time-out.Conduct a time-out immediately before starting the invasive procedure or making the incision.In the Universal Protocol Guidelines, the Joint Commission offers the following instruction for performing a time-out, and notes that the procedure should not start until all questions or concerns are resolved. So how, exactly, do you perform a time-out - and what is the Joint Commission looking for in assessing Universal Protocol compliance? And incidents have increased significantly in recent years.Įstablishing a time-out has never been more important to improve patient safety and support successful surgical outcomes. According to a recent article in Anesthesiology, the journal of the American Society of Anesthesiologists, there are around 650 operating fires annually, which result in at least two to three patient deaths per year. Surgical fires and burns are also on the rise. The Joint Commission estimates that less than 2% of all sentinel events are reported, so numbers are likely much higher. Of the 794 sentinel events reported by The Joint Commission in 2020, 68 were wrong-site surgeries. While awareness of wrong site, wrong procedure and wrong patient surgeries has improved, the problem persists. Safety protocols are followed and risk mitigation solutions are implemented according to the risk score. A point is given for each risk factor that’s present, including: procedural site above the xiphoid process, open oxygen source, presence of an ignition source. Many medical teams use the time-out to score patients for fire risk before surgery. In their recommendations to reduce the risk of a surgical fire, The Joint Commission stresses the importance of communication along with a recognition of the elements of the fire triangle - heat, fuel and oxygen - which must all be present to start a fire. The time-out is also an ideal time to assess fire risk. Pellegrini continues, “This initial time-out is an opportunity for other members of the team to share their thoughts, which seemed to set up the group for a good day every time.” Pellegrini, former chair of the department of surgery at The University of Washington Medical Center, Seattle, “A time-out breaks the ice at the beginning of the day with respectful discussion of the steps of the operation with the patient and team members, including potential challenges and a plan B if one is needed.” Dr. Beyond verifying site, procedure and patient, the time-out is an opportunity for the medical team to connect and build rapport.Īccording to Dr. ![]() This checklist takes under two minutes to complete and has been shown to reduce surgical complications and mortality by over 30 percent. The time-out is the first step in the World Health Organization’s Surgical Safety Checklist. While the time-out was introduced as a checkpoint to confirm the correct patient, procedure and site, it has become a cornerstone of a medical facility’s safety culture, and can significantly enhance surgical outcomes. Conduct a pre-procedure verification process.The Joint Commission’s Universal Protocol consists of three key steps: The time-out is a crucial step to preventing wrong-site surgeries, and a necessary step to comply with the Universal Protocol. Contributing factors often include poor communication, noncompliance with procedures, and a lack of leadership. The Joint Commission has identified several key factors that may explain the high number of these surgical mistakes. The Universal Protocol protocol was created in response to a pervasive problem of wrong site, wrong patient surgeries that continue to be an issue today. Introduced by the Joint Commission in 2003, this shared pause by the medical team prior to surgery is part of the Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery. In honor of this month’s National Time Out Day (June 10), we’re taking a closer look at this simple but invaluable surgical safety procedure. ![]()
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