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Expanded surgical time out: a key to real-time data collection and quality improvement
Terry Altpeter1, Kitty Luckhardt, John N Lewis
1University of Louisville Hospital, Department of Surgery, University of Louisville School of Medicine and Quality, Louisville, KY 40292, USA.
Journal of the American College of Surgeons
|March 27, 2007
Summary
Enhancing the surgical time out (STO) improved patient safety and quality by clarifying antibiotic timing, temperature control, and prophylaxis. Surgeon leadership and real-time data were key to this quality improvement tool.
Area of Science:
- Surgical Quality Improvement
- Patient Safety Protocols
- Healthcare Performance Enhancement
Background:
- Growing emphasis on quality improvement in healthcare.
- Surgical Time Out (STO) adoption is increasing to prevent wrong-site surgeries.
- The broader value of STO as a preoperative briefing and reflective pause is recognized.
Purpose of the Study:
- To describe an institution's experience with an enhanced Surgical Time Out (STO) technique.
- To validate the potential use of this enhanced STO by other institutions.
- To explore the broader value of STO beyond preventing wrong-site operations.
Main Methods:
- An enhanced STO protocol was implemented in a 400-bed teaching hospital during 2006.
- Pre- and post-implementation data were collected and analyzed.
- Performance metrics related to surgical care were evaluated.
Main Results:
- The enhanced STO clarified and improved performance in prophylactic antibiotic use, intraoperative temperature and glycemia management, and secondary issues like beta-blockade and venous thromboembolism prophylaxis.
- Surgeon leadership and real-time data collection were identified as essential components for success.
- The technique proved valuable in optimizing various aspects of surgical care.
Conclusions:
- Prompt feedback to surgeons is crucial for performance improvement.
- Identifying future targets for improvement is feasible with this method.
- Enhanced STO serves as a valuable tool for surgical safety, data collection, and quality improvement, especially in the context of pay-for-performance initiatives.
