Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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N E V E R E V E N T S PROVEN PRECAUTIONS procedure locations by signing consistent marks Reduce Wrong-Site Risks (initials work well) as close as possible to the 3. ID all sites. Note sites that can't be incision site. All site markings should be complet- marked — many ENT procedures, such as ed before patients are transferred to the OR. If a tonsillectomy, for example — on patient site cannot be marked, document the reasons in wristbands. You might already have a wrist- the surgical record. band system in place to alert the care team H ere are some practical ideas for ensuring you're performing the correct procedure at the correct site on the cor- rect patient, based on advice offered by the Joint • During time outs: After prepping solutions to patients with allergies, so maintain the SPOT CHECK Implement regular observation to ensure the surgical team performs effective time outs every single time. Commission in its Targeted Solutions Tool for and drapes have been applied, match patients' visual cue that everyone's familiar with. (Just make sure the site-alert bands are in a dif- identities and procedure locations — including ferent color.) The idea is to heighten awareness to ensure all procedures and sites are site and side — using wristbands or patient identified — regardless of whether they can be marked. overcoming common wrong-surgery oversights. • Before the day of surgery: Confirm that the patients and procedures listed on the case involvement against the signed surgical consent. schedule are accurate, and then ask physicians' Assign specific and consistent roles to each Buy-in and barriers member of the surgical team. For example, the The Joint Commission developed a Targeted Solutions Tool (TST) for wrong-site surgery schedulers to do the same. Establish and cultivate relationships with the schedulers to facilisurgeon and scrub tech should point to the tate this process. Never accept verbal requests marked surgical site and ask the surgical team to for surgery bookings. Instead, ask that schedverbally confirm that it's correct. Don't rush the ulers send booking forms to a single fax number time out, and limit noise and activity so they don't checked by a designated staff member. To distract the surgical team. Empower every team improve scheduling accuracy, ask schedulers to member to take part in the site verification and use standardized language and abbreviations, ensure they feel comfortable speaking up if they and legible handwriting if they're not typed. To have concerns over any part of the process. avoid forms slipping through the cracks, have a designated person in your facility manage the ON THE WEB — Daniel Cook collection of required paperwork. Joint Commission Center for Transforming • In pre-op: Ensure required documentation is Healthcare on hand and complete, including signed patient • Wrong-Site Surgery Targeted Solutions Tool consents, histories and physicals, and physiwww.centerfortransforminghealthcare.org/tst_ cians' orders. Have surgeons identify correct wss.aspx 2 4 SUPPLEMENT TO O U T PAT I E N T S U R G E R Y M A G A Z I N E | J A N U A R Y 2013 J A N U A R Y 2013 | S U P P L E M E N T TO O U T PAT I E N T S U R G E R Y M A G A Z I N E 2 5