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Toby's Take: Time Out!

Surgery team taking a time out during a procedure

July 26, 2022

Hey, do you want to go into Time Out?

“No!” one of my kids just might have snottily shouted now and again as they kept doing what they were doing.

They probably ended up in Time Out.

The name for this parenting tool, which my wife and I found worked a whole lot better when we were consistent at it, is one of those phrases that describes itself. A child takes a Time Out to help change behavior.

I think of that when I considered June 8 of this year, National Time Out Day, in the world of medicine. “Time out,” in this case, refers to a moment when a surgical crew stops what they’re doing right before starting a procedure to pause and review.

Borrowing from my blog last week: I heard someone say, “Okay, we’re taking a time out. This is Tobin Cook, date of birth 10-30-1967, and we’re doing a doing a colonoscopy. Do we agree?” Everyone responded, “Yes.”

Those were nice words to fall asleep to.

Carefully checking the list

“This is a moment of safety for the team,” said Melinda Loy, director of perioperative and procedural services in The University of Kansas Health System’s clinical arena. “We talk through the important elements of the procedure we’re about to perform. You have to speak up if something doesn’t feel right. If you see something, say something.”

Generally, a Time Out is announced, and each person in the room confirms what they know about their role in the procedure and flag anything that seems off. Everyone is empowered – encouraged – to speak. The best physicians insist on this.

Time Out has become a somewhat universally accepted way of heading off mistakes. By going through a mental and real-life checklist of what’s about to happen, the team stands an exponentially better chance of eliminating mistakes. Such as performing procedures on/with:

  • The wrong patient 
  • The wrong limb 
  • The wrong side 
  • The wrong position, resulting in nerve damage
  • The wrong anesthesia

This is a moment of safety for the team. We talk through the important elements of the procedure we’re about to perform. You have to speak up if something doesn’t feel right. If you see something, say something. – Melinda Loy

Director, Perioperative and Procedural Services

Making patient safety No. 1

Let me tell you something here.

I’m new to healthcare, and I try to write these for the reader who also has limited knowledge of the medical world. There are plenty of places that wouldn’t let me list these things in a blog because it might strike fear. You should take great comfort in knowing that the pros who perform these procedures at The University of Kansas Health System talk about this ad nauseum and precisely, so they don’t happen.

“We are not into firefighting. We are into fire prevention,” Whitney Huddleston said, “and we take that very seriously.”

Huddleston is also a director in our perioperative and procedural services area and works with Loy all the time to ensure patient safety.

Other considerations include patient allergies, whether to mark the spot of the procedure and if all risks have been explained.

The health system standardized much of the language used in a Time Out or other safety checks. It’s consistent with our goal to make patient safety No. 1, and that’s not a talking point.

“Always the right thing, the right patient, the right equipment, every time,” Huddleston said. She and Loy are adamant that everything their teams do surrounds “chasing zero harm.”

In other words, nothing happens to make things worse for a patient, only better. It’s become so routine here, and that’s a very good thing.

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