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Time out procedure checklist8/3/2023 Finally, as an additional verification of observed data, we queried our institution’s perioperative data warehouse for the electronic time stamps associated with each step of the electronic time-out that occurred between August 2010 and December 2016. We therefore sought to identify nonroutine events that occur during the time-out procedure in the operating room, including distractions and interruptions, deviations from protocol, and the problem-solving strategies used by operating room team members to mitigate these nonroutine events. Poor time-out execution, caused by nonroutine events, may diminish the expected beneficial effects of the time-out. 9ĭespite those findings, little is known about the quality of execution of the time-out in routine clinical practice. Two previous studies conducted at Vanderbilt University Medical Center demonstrated that this electronic time-out application has both improved overall compliance with performing time-outs 8 and decreased wrong-surgery events relative to estimates of national wrong-surgery rates. A nurse then documents these responses electronically by checking boxes within the electronic time-out application, which brings up the next question. As each step of the time-out is verbalized by a team member, the operating room team members are expected to respond. The circulator nurse normally runs the electronic time-out application using an operating room computer and is responsible for guiding the team through each item. 8, 9 The electronic time-out uses an electronic whiteboard (40-inch television screen) to display a checklist with checkboxes for each component of the time-out. 4– 7 At Vanderbilt University Medical Center, an interactive electronic time-out was implemented in 2010 to increase surgical team compliance with the time-out procedure and to improve communication between team members in the operating room. Implementation of the time-out procedure has been associated with a decrease in preventable medical errors, patient morbidity, patient mortality, and surgical complication rates. 3 The time-out is also a time designated for team members to voice any concerns about the patient’s safety or the procedure. 2 During the time-out, the entire operating room team reviews the patient’s identity, the procedure, and the surgical site before surgical incision or the start of the procedure. 1 According to the protocol, organizations must conduct a “time-out” before the start of any surgical procedure. The universal protocol was designed by the Joint Commission to reduce the occurrence of wrong-site, wrong-procedure, and wrong-person surgery.
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