It’s now standard practice in ERs and ORs across the land to perform a “Time Out” — a brief pause before starting a significant procedure (say, an amputation or a chest tube placement) — at which point everyone on the team verifies that they’re about to do the right procedure on the right patient on the proper side.
The practice of “Time Outs” makes everyone feel better that they’re not about to do something catastrophically wrong, and may prevent a rare, rare error now and then. Plus, it’s required.
But now, researchers at Johns Hopkins are advancing a more thorough practice: the brief Time Out is being challenged by a 2-minute conversation, in which participants talk about themselves, their perceived role in the procedure, and who knows what else.
The briefing consists of a two-minute meeting during which all members of the OR team state their name and role, and the lead surgeon identifies and verifies such critical components of the operation as the patient’s identity, the surgical site and other patient safety concerns. The briefing is performed after anesthesia is administered and prior to incision.
Ah, perfect. The Hopkins guidelines take great care to make sure everyone is on the same page, that everyone relevant has expressed themselves… except they also require that the patient be asleep. You know, in our experience, sometimes the patient can be helpful in identifying themselves and the reason they’re having surgery.
Don’t get us wrong — we’re all for time-outs, but we suspect the added benefit of two minutes of forced conversation is significantly undercut by sedating the one person who’s got the most at stake — the patient.
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