Surgical Timeout Failure = Surgeon Engagement Failure

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Surgical Timeout Failure = Surgeon Engagement Failure

Despite the incorporation of a surgical timeout in every OR, surgical “never events” still persist. Surgical “never events” include: 1) operating on the wrong patient or wrong surgical site, 2) performing the wrong procedure, 3) overlooking a retained foreign body, and 4) the death of an ASA Class 1 patient in the perioperative period. I submit that the failure of a surgical timeout to protect a patient is due to the failure of surgeon engagement.     

  • The surgeon should lead the timeout and ensure that each member of the team actively participates. If any team member is not paying attention during the timeout, the surgeon should remind everyone to focus on the patient’s care. All members of the team should speak at a deliberate pace, giving their names, their role, confirming their identification of the surgical site, and expressing any concerns for the patient’s care.
  • A consistent pattern should be used to mark the patient’s surgical site. Everyone in the room should be required to personally identify the site and review the written consent.
  • The surgical timeout checklist should be visibly placed so that everyone can follow along to ensure that all steps have been addressed and nothing is missed.

Jeffrey M. Nakano, MD
[email protected]

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