Outpatient Surgery Magazine - Subscribers

Clear Cut - July 2015 - Outpatient Surgery Magazine

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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Byrum, the CEO and co-founder of HRS Consulting. "Consistent, replicable processes and procedures are the most reliable defensive tools for the team that cares enough to do a quality time out. We owe our patients nothing less." Of our survey respondents, 11% acknowledge that the marks made in their facilities vary, depending on the surgeon. "Typically, it's the surgeon's initials, but occasionally it's a line," says one administrator. "We use an 'X,' YES or the patient's initials," says another. That kind of variety, experts say, is a recipe for trouble. "We don't do 'X' because there could be confusion as to whether 'X' means not this site or yes, this site," another facility leader correctly points out. Do arrows, dots or patient initials, which might be made by anyone, downplay the essential nature of the surgeon's understanding and acknowledgement? The mark you use, says the protocol, must be "unambiguous" and "used consistently throughout the organization." Who's responsible? Studies show that among the most common factors contributing to wrong-site surgery are lack of standardization, lack of clear policies and failure to clearly identify responsibilities. The protocol is clear: The responsibility for marking the surgical site belongs to the "independent practitioner who is ultimately accountable for the procedure and (who) will be present when the procedure is performed." In "limited circumstances," it continues, responsibility "may be delegated to some medical residents, physician assistants or advanced practice registered nurses." One gets the feeling that there's considerably more delegating going on than the authors envisioned. In fact, more than 3% of our survey respondents say either the pre-op nurse or the OR nurse is responsi- 4 6 O U T P A T 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 | J U LY 2 0 1 5

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