SURGICAL "TIME OUT” FOR SAFETY

Hospitals, nurses and physicians are dedicated to ensuring the safety of their patients. With more than a half million surgical procedures taking place every year in Wisconsin hospitals, nurses and physicians follow strict processes to ensure that they have the correct patient, the correct procedure and the correct site.

In addition to the internally developed policies that hospitals have in place, as of July 1, 2004 all hospitals that are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are required to take a "time out” before surgery begins. The "time out” is a final step before a surgical procedure to verify that the correct procedure will be performed on the correct patient. JCAHO accredits 109 hospitals in Wisconsin.

Patients are encouraged to be strong and effective partners in working with doctors, nurses and other caregivers to ensure that no mistakes or errors occur in their care. In particular with surgical procedures, patients and their families are encouraged to have ongoing communication that reinforces the correct site for the surgical procedure. Surgery patients at Lakeview Medical Center (LMC) have been participating in surgical site marking since 1999.

"We don't want to take anything for granted,” said Sandy Harm, Quality Improvement and Patient Safety Director at LMC. "Prior to surgery, each surgical patient knows we will be verifying their name, marking the surgical site and verifying what procedure will be performed.” In addition to the "time out” with the patient, the surgical team performs a second "time out” minutes before surgery.

"Our surgical teams are dedicated to safeguarding patients from errors,” said Doris Ruiter, Director of Surgery at LMC. "In addition to surgical "time outs,” we have many additional safety efforts in place including the elimination of many medication abbreviations and verbally repeating spoken orders to safeguard against errors in the communication process.”

Many efforts across the country are underway to increase patient safety and identify the cause of errors. The healthcare community is taking active steps to reduce errors, and to encourage patients to become full partners in decisions about their care and treatment.

Advice for Surgery Patients from the Association of periOperative Registered Nurses (AORN):

• If you are having surgery or any other invasive procedure, make sure that you and the health care professionals treating you all agree on exactly what will be done during the surgery or procedure.
• Verify the information on your patient identity bracelet. Alert a member of the health care team if the information is incorrect and insist that it be replaced immediately.
• Make sure the operative permit you sign includes the correct information about your surgical site (i.e., right or left) and procedure. Thoroughly read all medical forms and make sure you understand them before you sign anything.
• Ask to have the surgical or procedure site marked on your body with an indelible marker. If possible, be involved in marking the site.
• Ask questions and speak up if you have any concerns. Keep asking questions until you understand the answers. Ask members of the healthcare team what steps will be taken to ensure your safety and correct site surgery.
• Take a responsible family member or friend to accompany you to your doctor's visits and on the day of your surgery or procedure so that they can serve as your advocate and speak up for you if you are unable.
• Make sure that any post-surgery instructions are given to you prior to your surgery, preferable in writing. Also, make sure a friend or family member is present when the directions are being given. This will help reduce your overall stress and ensure that as many parties as possible are fully informed.

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