and the rest of the staff — some of whom
could be indifferent and view time-outs as just
another "nursing thing" that doesn't concern
them. The real danger is documenting on the
chart that a timeout had occurred, even
though half the team didn't participate.
An effective way to enforce team compli-
ance and maintain structured time-outs is to
make one person responsible for initiating the
timeout. In most ORs, it's the circulating
nurse. When we polled our readers to find out
who initiates the time-out at their facility, 79%
said the circulator and 10% said the surgeon.
Another 10% said it varies — sometimes it was
the anesthesiologist, sometimes the surgeon,
sometimes the nurses. This inconsistency is
dangerous.
Similarly, there's a time (before the incision
is made or procedure begins) and a place (the
OR) when you should take a timeout. Not in
pre-op/holding, not immediately after intuba-
tion and not as soon as the surgeon walks in
the OR. No, the best time to perform a time-
out is before induction or sedation. Safety
experts say letting the patient actively partici-
pate in the time-out adds another layer of pro-
tection.
While experts say it's ok to conduct an infor-
mal timeout in the pre-op area to go over surgi-
D E C E M B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 7 7
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