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F E B R U A R Y 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
reason, other variables have been introduced — a distraction, a delay
or something like that. And when they resume, there's a wrong site or
wrong procedure."
What kinds of distractions? "Unfortunately, around the country
there have been multiple reports of people doing time outs with
everybody else on their phones, checking e-mails, texting, looking at
Facebook or whatever," says Peter Papadakos, MD, of the University
of Rochester (N.Y.) Medical Center. "People can be distracted by
work-related stuff, too, people on the computer, finishing up the pre-
op on the EMR and going, 'Uh-huh, uh-huh,' but their back is turned.
Or maybe the anesthesiologist is still completing the anesthetic
record, that kind of thing."
Donna Ford, MSN, RN-BC, CNOR, a nursing education specialist at
the Mayo Clinic in Rochester, Minn., recommends asking if everyone
is ready for the time out, and waiting until everyone says yes. "If a cir-
P R E - O P S A F E T Y
and respect what that person is saying," says Mr. Byrum. "One real chal-
lenge that we have is when the person speaks up and their concern is
immediately squashed or dismissed. The likelihood of that person ever
speaking up again, especially on that surgical team but maybe in any
context, will be reduced."
That's exactly why David Ring, MD, goes out of his way to make sure
people voice any concerns. "In the operating room, people will speak up
— a nurse, a resident, an anesthesiologist – and say, hey, what about
this. And 99 times out of 100 you meant to do it that way and it's fine," he
says. "But I always say thanks for speaking up: I mean to do it this way,
but I'm glad you spoke up because if I weren't supposed to do it this
way, you would have really saved me from making a mistake."
— Jim Burger
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