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Observational Study
. 2014 Jul 3;4(7):e005075.
doi: 10.1136/bmjopen-2014-005075.

Compliance with a time-out procedure intended to prevent wrong surgery in hospitals: results of a national patient safety programme in the Netherlands

Steffie M van Schoten  1 , Veerle Kop  1 , Carolien de Blok  2 , Peter Spreeuwenberg  1 , Peter P Groenewegen  3 , Cordula Wagner  4
Affiliations
Observational Study

Compliance with a time-out procedure intended to prevent wrong surgery in hospitals: results of a national patient safety programme in the Netherlands

Steffie M van Schoten et al. BMJ Open. .

Abstract

Objective: To prevent wrong surgery, the WHO 'Safe Surgery Checklist' was introduced in 2008. The checklist comprises a time-out procedure (TOP): the final step before the start of the surgical procedure where the patient, surgical procedure and side/site are reviewed by the surgical team. The aim of this study is to evaluate the extent to which hospitals carry out the TOP before anaesthesia in the operating room, whether compliance has changed over time, and to determine factors that are associated with compliance.

Design: Evaluation study involving observations.

Setting: Operating rooms of 2 academic, 4 teaching and 12 general Dutch hospitals.

Participants: A random selection was made from all adult patients scheduled for elective surgery on the day of the observation, preferably involving different surgeons and different procedures.

Results: Mean compliance with the TOP was 71.3%. Large differences between hospitals were observed. No linear trend was found in compliance during the study period. Compliance at general and teaching hospitals was higher than at academic hospitals. Compliance decreased with the age of the patient, general surgery showed lower compliance in comparison with other specialties and compliance was higher when the team was focused on the TOP.

Conclusions: Large differences in compliance with the TOP were observed between participating hospitals which can be attributed at least in part to the type of hospital, surgical specialty and patient characteristics. Hospitals do not comply consistently with national guidelines to prevent wrong surgery and further implementation as well as further research into non-compliance is needed.

Keywords: SOCIAL MEDICINE; SURGERY.

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Figures

Figure 1
Figure 1
Trend in the time-out procedure compliance per hospital type, and overall mean (n=1232).
See this image and copyright information in PMC

References

    1. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. 6th edn Joseph Henry Press, 2000 - PubMed
    1. See LC, Chang YH, Chuang KL, et al. Animation program used to encourage patients or family members to take an active role for eliminating wrong-site, wrong-person, wrong-procedure surgeries: preliminary evaluation. Int J Surg 2011;9:241–7 - PubMed
    1. Seiden SC, Barach P. Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable? Arch Surg 2006;141:931. - PubMed
    1. Zhan C, Kelley E, Yang HP, et al. Assessing patient safety in the United States: challenges and opportunities. Med Care 2005;43:42–7 - PubMed
    1. WHO. Patient Safety. 2013. http://www.who.int.

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