when the time out occurs. Your docs must take ownership of the time
out and set a positive example by demanding that all activity comes to
a full stop and that every team member is focused and participating.
Hello, my name is … Team members should introduce themselves
(or be prompted to speak) during the time out, because staff who
talk during that last safety check are more likely to alert the surgeon if
something seems amiss during surgery. The surgeon should make that
point very clear by stating, "If you see something that would cause risk to
the patient, I expect you to let me know."
Beware of information overload. Don't cover too much informa-
tion during the time out. Doing so might compel the surgical team
to rush through a series of steps that would have been best addressed
during the pre-op briefing, which is distinct and separate from the time
out. Time outs should be reserved for focusing on the key safety points:
ensuring the right patient is on the table; the correct operation is about
to occur; and the correct site is marked, visible and confirmed. You also
want to ensure SCIP measures have been carried out, pre-op antibiotics
were given at the appropriate time and everyone in encouraged to speak
up if patient safety is jeopardized.
Use scripted phrases. It can be difficult for nurses and techs to
alert surgeons when safety concerns arise. Surgeons are often
viewed as the most powerful person in the room, and there's a strong
tendency for staff to defer to their command. Simple scripted phrases
that escalate in urgency can help team members speak up:
• I'm concerned or need clarity.
• I'm uncomfortable.
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