Time-out Attestation Tool Results in Sustained Improvement in OR Team Participation, Communication

January 29, 2014 | Strategic Insights for Health System


A preprocedural checklist format that mandates the personal attestation of each member of the operating room (OR) team regarding their specific participation in the preprocedure “time-out” improved compliance with the time-out, according to a study published in the January 2014 issue of Joint Commission Journal on Quality and Patient Safety. An observational study conducted in a Washington community teaching hospital with 24 ORs served by three surgical groups revealed inadequate compliance with its adopted version of the World Health Organization’s Surgical Safety Checklist built around a time-out immediately before incision. An observational audit of the facility’s time-out process, in which the surgeon leads the time-out, identified inadequate participation by all OR team members and revealed lack of uniformity in completion of the checklist across OR sites. Nurses and surgical technicians were least compliant with the time-out process. Consequently, representatives from surgery, nursing, surgical technicians, and anesthesiology working together, revised the format of the checklist with the goal of achieving sustained improvement in participation and communication. The revised format, a preprocedural attestation pause tool, mandates each member of the team, sequentially, to speak out their first and last names and attest to their specific participation as designated in the checklist.

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