Time outs play an important role in reducing wrong-site, wrong-side, wrong-patient and wrong-procedure surgeries, as they give the provider team a chance to step back prior to incision and agree on the intended procedure. However, even though time outs have been around for 10 years now, wrong-site surgeries persist.
In fact, 40 to 60 wrong-site surgeries occur weekly in the nation — and a defect in the time out process is the attributed cause of 72 percent of analyzed wrong-site surgeries, according to statistics from the Joint Commission Center for Transforming Healthcare.
"The safety measure…continues to have some holes in it because we're not making the progress we should have with the time out procedure," says Linda Groah, RN, MSN, CEO of the Association of periOperative Registered Nurses.
National Time Out Day, an awareness campaign initiated by AORN, is celebrating its 10th anniversary this year on June 11. In honor of National Time-Out Day, Ms. Groah provided the following tips to improve compliance with time out standards.
• Remind caregivers of their role. "Every member of the team has the responsibility and accountability to the patient to provide patient-centered care," Ms. Groah says, which includes ensuring a safe, never-event-free perioperative experience. That means every practitioner, like surgical technologists, perioperative nurses, surgeons and anesthesiologists, can refuse to participate in the surgery until the proper time out procedure is followed.
However, bullying and intimidating behavior can result in team members feeling unsafe about speaking up about patient safety, and a "code of silence" can develop in the OR, Ms. Groah explains. "A young nurse can be very frightened of that," she says.
• Get leadership behind the push. The "code of silence" makes leadership involvement even more paramount in successfully implementing time out procedures. Hospital and health system CEOs and board members "have to demand that the Universal Protocol, which includes the time out, is adopted and implemented and, if it isn't, there has to be some retribution," Ms. Groah says. "There must be some teeth in the protocol for us to make the progress we need to make."
Additionally, OR managers and directors need to take a role in complying with time out protocol. "[They] need to be supportive of the staff and encourage them to speak up," she says. "The manager can really set the tone for individual practitioners in the OR."
For more on the importance of time outs and National Time Out Day, see this article in the AORN Journal.