Monday Med Mania

Time Out Procedure

I consulted on a case that rested solely on the "Time Out" procedure used in the operating room. All the documentation was neatly in order, yet somehow the patient ended up having the wrong part removed. Finally, inconsistent stories emerged as each inidividual member of the surgical team was deposed. The deviations in standards of care surrounding the "Time Out" procedure were clearly identified:

• The operating was noisy during the "Time Out"
• The attending physician was not even present when the "Time Out" took place
• A right-left distinction was never identified during the "Time Out"

Surgical team members must remeber that the "Time Out" procedure was put in place for a reason. We don't do "Time Out" just to satisfy Joint Commission requirements - We do it to protect the patient. The attending physician has to be present, and the "Time Out" must take place just prior to the surgery in a quiet room. A right-left distinction must be clearly identified, and if the surgery requires more than one procedure, a new "Time Out" must be done before each individual procedure. This process eliminates the risk of wrong site, wrong procedure or wrong person surgery.

I came across one facility's Universal Protocol on the internet for "Time Out" procedure which identifies the process that must be followed: Universal Protocol - Time Out. This may help those that need clarification with the process. There are also some helpful videos on YouTube that actually simulate the process as well. For more information on "Time Out" Procedures or other Universal Protocols you may email us at mcook@cook-legalnursing.com.