Why not belt it out, if that's what it takes? After all, virtually every-
body in health care agrees that patient safety is — or at least should
be — paramount. Our latest reader survey underscores the dedication
and tireless work facility leaders are putting in toward keeping their
patients safe. But the challenges they continue to face also come
through loudly and clearly.
A failure to engage in time outs is one of the pain points, as are time
pressures, communication and, most disconcertingly, an observed
willingness on the part of staff and physicians to at least occasionally
take shortcuts that could affect safety. Here's some of what respon-
dents had to say.
When it comes to time outs, only 73% of our nearly 400 respondents
say they can always count on full engagement from OR staff. A com-
mon theme pops up again and again. "It's difficult to engage the sur-
geons," says a director of surgical services from Oklahoma. "I some-
times feel that the surgeon is not paying attention," adds a clinical
director from a Texas surgery center. "We complete a full time out,"
says a suburban New York administrator, "but at times we feel sur-
geons are not paying 100% attention."
Surgeons undoubtedly would like proof that time outs do more than
just waste their valuable time. But to convince them, you may have to
rely on a different tact.
Elizabeth Hall-Findlay, MD, FRCSC, a plastic surgeon and the med-
ical director of Banff Plastic Surgery in Alberta, Canada, says insisting
on a fully engaged time out comes down to common sense. "I just do
not understand why surgeons resist," she says. "I was criticized [by
other physicians] at a meeting once for not limiting the time out, but
when we do them at our facility, we actually cover more than the
patient, site and side."
Dr. Hall-Findlay says she also asks about cautery settings and implant-
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