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Timeouts need to include the entire surgical team

Quality Improvement Monitor, October 10, 2008

Hospitals that want to comply with The Joint Commission’s new Universal Protocol™ expectations beginning January 2009 should ensure that their surgeons mark the site and the entire surgical team commits fully to the timeout.

“When surveyors are in the operating room for tracer activities, they are looking to see team involvement and recognition when timeouts are done,” says Clint Chain, RN, quality manager at United Surgical Partners International, a Texas-based company that manages surgery centers nationwide.

Hospitals sometimes get cited by surveyors if the circulator or the technician doesn’t stop what he or she is working on to take part in the timeout. “They even want to see the anesthesia provider behind the drapes pop their head out,” Chain says.

Surveyors will also likely try to make sure that the surgeon, not the preop nurse, does the site marking. In the past, the Universal Protocol indicated that the surgeon should mark the site, which many interpreted to mean that if the physician wasn’t available, it was acceptable for another member of the perioperative team to perform the site marking. However, this is no longer the case. The elements of performance for 2009 now definitively state that the site must be marked by the person performing the procedure or a qualified person who will also be participating in the procedure.

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