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Related Experiment Video

Updated: May 7, 2026

Optimizing Minimally Invasive Spine Surgery: A Fully 3D CT O-Arm Navigated Workflow in MIS TLIF
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Published on: October 17, 2025

Using "near misses" analysis to prevent wrong-site surgery.

Richard S Yoon, Michael J Alaia, Lorraine H Hutzler

    Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
    |September 17, 2013
    PubMed
    Summary

    Surgical education significantly reduced near-miss events like wrong-site surgery bookings and time-out errors. This intervention improved patient safety by decreasing procedural errors and preventing potential harm.

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    Area of Science:

    • Patient Safety
    • Surgical Education
    • Healthcare Quality Improvement

    Background:

    • Wrong-site surgery remains a persistent issue despite guidelines, with an estimated 40 weekly occurrences in the US.
    • Near misses, such as incorrect surgical bookings and improperly performed time-outs, are precursors to "never events" like wrong-site surgery.
    • Near-miss analysis is a critical tool for preventing rare but severe adverse events in healthcare.

    Purpose of the Study:

    • To reduce near-miss events related to wrong-site surgery.
    • To decrease the incidence of incorrectly sided surgical bookings.
    • To improve the performance of preoperative time-out procedures.

    Main Methods:

    • A pre-post intervention study was conducted at an academic orthopedic surgery institution.
    • Near misses were tracked using an electronic database (Patient Safety Net).
    • Educational interventions were provided to surgeons and staff regarding accurate bookings and time-out procedures, with offenders counseled.

    Main Results:

    • The rate of incorrectly booked surgical cases decreased from 0.75% to 0.41% (p = .0139).
    • Improperly performed time-out procedures dropped from 18.7% to 5.9% (p < .0001).
    • These reductions were observed across 12,215 analyzed cases.

    Conclusions:

    • Educational programs targeting near-miss reduction are effective in improving surgical safety.
    • Decreasing near misses for wrong-site surgery directly lowers the probability of these critical errors occurring.
    • This study highlights the importance of targeted education in preventing serious patient harm in surgical settings.