Page 51 - Part 1 Anesthesiology Common Risk Issues

SVMIC Anesthesiology: Common Risk Issues

Time-Outs

“Time-outs” are essential communications between the
members of the surgical/procedure team. While usually

considered as a safety measure for surgeons to prevent harm
as a result of operating on the wrong patient or the wrong

site or performing the wrong procedure, time-outs are equally
important to anesthesia providers as well.

Anesthesiologists are involved in a growing share of “sentinel

events”, especially involving wrong-site local and regional
anesthesia blocks. One possible explanation may be that

anesthesiologists have not been as willing to adopt the
Universal Protocol — marking the site and performing the

time-out. Performing a time-out prior to starting a block is the
recommended practice.

In addition to performing time-outs prior to nerve blocks,
anesthesia practitioners should be actively involved in surgical

time-outs. At different stages of the procedure, other elements
are verified, including the plan for the procedure and team

member assignments, as well as the best ways to communicate
with team members during the procedure. Checklists are

extremely effective during the operation and postoperatively as
they contribute to improved patient outcomes. It is important

to note that strong team member commitment is key to the
successful implementation of checklists in preventing harm to

patients and improving quality.

Many practitioners believe a time-out breaks the ice at the
beginning of the day with respectful discussion of the steps

of the operation with the team members, including potential
challenges and a “Plan B” if one is needed. This initial time-out

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