patient is always right. Sometimes they're confused, or it could be an
issue of a bilateral disease.
Misperception is when the surgeon or staff mixes up the left and
right, or the front and back, of the patient despite having the correct
information. Twenty percent of the population has right and left con-
fusion, meaning that they can't immediately tell their right from their
left without having to think about it first. That means if I say, "Raise
your right hand" to a group of people, 20% might raise their left or
have to take a few moments to think about it.
Q
Has the Universal Protocol helped?
Many people just go through the motions when it comes to
the Universal Protocol. Generally, nurses are trying to do the
right thing. The physicians are not always as enthusiastic. That's
because the reality is that if you ignored the Universal Protocol and
never bothered with it, 3 out of 4 doctors, aside from spinal surgeons,
would never experience wrong-site surgery. The problem is that a facil-
ity doing 10,000 operations a year wouldn't have that same luck. But,
for the doctors, the chances are so low they don't give credence to it.
It isn't so much that the Universal Protocol isn't being followed. It's
that the Universal Protocol never specifies how things should be
done. It gives facilities a checklist of things to do — mark the site,
perform a time out — but doesn't really specify the exact ways to do
those things. It turns out that when you look closely, as we have and
Minnesota has, there are ways of doing things that are going to make
errors less likely than other ways.
Q
Can you give some examples?
For one, make sure that the very specific site of operation is
listed on all documents. It needs to be very detailed and list-
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January 2015 | O U T PAT I E N TS U R G E R Y. N E T
