Timeout procedure in paediatric surgery: effective tool or lip service? A randomised prospective observational study

Area of Science:

• Medical safety
• Surgical procedures
• Patient care

Background:

• The preoperative timeout is a standard safety protocol in pediatric surgery.
• Its effectiveness in detecting errors has not been systematically evaluated.
• This study assesses the detection rate of introduced errors during timeouts.

Purpose of the Study:

• To evaluate the effectiveness of the preoperative timeout procedure in detecting deliberately introduced errors.
• To identify which team members are most likely to report errors during timeouts.

Main Methods:

• Deliberate errors (e.g., wrong patient name, incorrect site) were secretly introduced during timeouts for elective pediatric surgeries.
• The study monitored the frequency and source of error reporting by the surgical team.
• Data were collected over 16 months involving 1800 operations.

Main Results:

• Out of 1800 timeouts, errors were introduced in 120 cases (6.7%).
• Overall, 54% of introduced errors were detected and reported by the team.
• Anesthesiologists reported the majority of errors (64%), followed by nursing staff (28%).

Conclusions:

• The current preoperative timeout procedure is unreliable, with nearly half of introduced errors going unnoticed.
• Despite strict implementation, mistakes can be overlooked, indicating a need for enhanced safety measures.
• Further research is needed to develop and validate improved surgical timeout protocols for better patient safety.