Frequency of intra-operative changes as a result of the surgical “time out”

Communication breakdowns are a common cause of surgical errors and adverse events. Nagpal K, et al [Ann Surg. 2010 Aug; 252(2): 225-39] conducted a systematic review of published literature to gain a better understanding of information transfer and communication in the operating room setting. Information transfer failures are common in surgical care. They not only lead to errors in care provision, but also lead to patient harm. There is a need for standard measures to evaluate this process. Effective and standardized communication among healthcare professionals during the intra-operative process facilitates surgical safety. Various studies have shown that the use of a checklist in the operating room lowers mortality and morbidity related to the act of anesthesia and surgery. The World Health Organization launched a program in June 2008 to improve the safety of surgical care with the use of a simple tool: Surgical Safety Checklist. Now studies are beginning to generate data to measure the impact of the WHO's surgical safety checklist on in-hospital mortality. It has been demonstrated that checklist briefings reduced the number of communication failures and promoted proactive and collaborative team communication. The primary outcome in one particular study [Lingard L, et al. Arch Surg. 2008 Jan;143(1): 12-7] was the number of communication failures per procedure. Just as useful and interesting was the secondary outcome: the number of checklist briefings that demonstrated "utility" (an effect on the knowledge or actions of the team) and participants' perceptions of the briefing experience.