modified it," says Dr. Molina.
The logistics of getting a patient into the OR will vary from one facil-
ity to another — and your checklist should reflect those site-specific
challenges, says Dr. Molina. For example, facilities that do a lot of
cases where there's an open oxygen source and a heat source in close
proximity might incorporate a fire risk assessment score into their
safety checklist.
Errors are going to happen in the OR, says Dr. Molina. Just as an
anesthesiologist could miss a patient's allergies, a surgeon could just
as easily confuse one patient for another or mark the wrong leg for
surgery. The checklist gives everyone an equal opportunity to speak
up. It's the difference between a mistake that's caught, and a mistake
that leads to serious consequences.
"Having these hard pause points leads to better care," he says.
A safe takeoff
Most safety breakdowns stem from poor com-
munication, says Dr. Wahr. "You should always
ask: 'What do I know that other people in the
room don't know?'"
An example: Dr. Wahr remembers treating a
Jehovah's Witness who needed a hip replace-
ment. As the anesthesia provider, Dr. Wahr
learned her patient could not accept a blood transfusion — doing so
during medical care goes against the religious group's beliefs — and
she alerted the surgeon. That kind of communication makes the dif-
ference between a smooth procedure and one that takes an unexpect-
ed turn.
"It became a part of our briefing," says Dr. Wahr. "She's a Jehovah's
Witness, but with her hemoglobin volume she should be able to lose
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Joyce Wahr, MD
