165 - Time Out: Illuminating Every Step Toward Safer Surgery

Description:

Introduction:
The surgical time-out is a critical safety pause mandated to prevent wrong-site, wrong-procedure, and wrong-person surgeries. Despite its widespread adoption, inconsistencies in how time-outs are conducted can undermine patient safety and team communication.

Purpose:
This quality improvement initiative aimed to enhance the consistency, engagement, and effectiveness of the surgical time-out process across all operating rooms by implementing an audit tool and structured education.

Methods:
A standardized time-out checklist was developed based on national safety guidelines, including those from The Joint Commission and AORN. An audit tool was created to evaluate compliance, clarity, and participation during time-outs. Baseline data were collected over a 4-week period. Following this, targeted educational sessions were provided to perioperative team members, emphasizing the purpose, elements, and shared responsibility of the time-out. Post-intervention audits were conducted to assess improvement.

Results:
Audit results demonstrated a significant improvement in adherence to the surgical safety checklist, active interdisciplinary participation, and clear verbalization of critical safety elements. The rate of complete and standardized time-outs rose from a baseline of 13% to 93% following the intervention. Staff reported enhanced confidence and a clearer understanding of their roles during the time-out process.

Conclusion:
Changing the audit tool into standardized checklist on the whiteboard combined with focused education significantly improved the cohesiveness and reliability of the surgical time-out process. Standardization and team accountability were key drivers of this improvement. Sustaining this change requires ongoing audits, feedback, and integration into orientation for new perioperative staff.