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Experimental Paradigm for Measuring the Effects of Self-distancing in Young Children
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The Time Out Procedure: have we changed our practice?

Alex J-J Lee1, Sumit Raniga, Gary Hooper

  • 1Department of Orthopaedic Surgery, Christchurch Hospital, Riccarton Avenue, Private Bag 4710, Christchurch 8011, New Zealand. jaejinl.lee@cdhb.govt.nz

The New Zealand Medical Journal
|November 27, 2012
PubMed
Summary
This summary is machine-generated.

Surgical safety checklists like the "Time Out Procedure" (TOP) effectively prevent wrong-site surgeries. While checklist use improved, surgeon resistance remains a barrier to optimal patient safety.

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Area of Science:

  • Medical Safety
  • Surgical Procedures
  • Quality Improvement

Background:

  • A
  • Time Out Procedure
  • (TOP) surgical safety checklist was introduced in three major Christchurch hospitals in 2004.
  • A prospective analysis was conducted at implementation and four years later.

Purpose of the Study:

  • To evaluate the effectiveness of the TOP in preventing wrong-site surgeries.
  • To assess changes in TOP completion rates and discrepancies over time.
  • To analyze surgeons' attitudes towards the TOP.

Main Methods:

  • Prospective analysis of 10,330 procedures (Phase 1: 2004-2005) compared to 25,086 procedures (Phase 2: 2008-2009).
  • Recorded surgical team members and discrepancies during the TOP.
  • Surgeon attitudes were assessed via questionnaire.

Main Results:

  • No wrong-site operations occurred in either phase.
  • TOP completion improved significantly from 87% to 98% (p<0.001).
  • Observed discrepancies increased from 7.7% to 9.3% (p<0.001), often due to surgeon absence (73%).

Conclusions:

  • Surgical checklists like the TOP are valuable tools for preventing wrong-site surgery.
  • Practices for consent and limb marking improved.
  • Surgeon resistance to checklists persists, necessitating further research into underlying reasons and solutions.