7 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 9
over the non-operative eye.
• When the surgeon meets with the patient in pre-op, he should dis-
cuss which eye he'll operate on, doublecheck the paperwork and sign
his initials next to the sticker.
The process doesn't end there. Ms. Clairmont says the circulating
nurse confirms the correct eye with the patient when she arrives in
pre-op and the anesthesia provider does the same when he explains
the retrobulbar block he's about to place. A pre-op time out is per-
formed in the operation room, during which the staff and surgeon
refer to the booking sheet to once again confirm the correct eye.
Joint Commission surveyors have given the process rave reviews,
says Ms. Clairmont, "because it was consistent for every patient. The
surveyors were here for a couple days, followed patients into the oper-
ating room and would see that we followed the same approach to
marking the correct eye before each and every procedure."
Individualized patient care is important for satisfaction scores, but
not site marking. The process in place at Vermont Eye was designed
for cataract surgery, but its fundamental principles — a standard-
ized, learned script — can serve as a lesson for any surgical team in
any type of facility. "You hear all of us saying the same things, asking
the same questions to every patient before every case," says Ms.
Clairmont.
That's not to say the process is executed perfectly every time. No
process is. But the beauty of implementing multiple checks into
the site-marking process is that inevitable miscues are less likely
to result in a wrong-site surgery. When gaps in protocols do occur,
address them immediately.
If, for example, an anesthesia provider at Vermont Eye administers a
block before the surgeon had a chance to visit with the patient and
confirm the correct eye, the team gathers to figure out why. "We get
