Atul Gawande recently (3.15.14) discussed Time Out and implementation.
The point of the Time Out Project is to provide potential solutions to implement Time Out powerfully and effectively.
Quote from Gawande article:
“My suspicion is that a government mandate without a serious effort to change the culture and practice of surgical teams results in limited change and weak, if any, reduction in mortality.
But it’s hard to know from the Ontario study. Without measuring actual compliance with using the checklist, it’s like running a drug trial without knowing if the patients actually took the drug.
Perhaps, however, this study will prompt greater attention to a fundamentally important question for health care reform broadly: how you implement an even simple change in systems that reduces errors and mortality – like a checklist.
For there is one thing we know for sure: if you don’t use it, it doesn’t work.”
Here’s Dr. Cliff Stermer and I, filming the first-ever Woodhull Hospital Medicine Time Out training video! The Time Out, or safety checklists designed to check for correct patient, procedure, site and side, is crucial to avoiding error, like infection, complications, even death. Yet it’s not ingrained in medicine culture, as it is in surgery.
Dr. Edward Fishkin and I wrote the script, with Jon Ehinger, director of this film, in February 2013. So exciting to finally have this – and fun to film with the medical students and staff!
We are showing this video to staff on the floor and in the OR immediately before they conduct their procedures, “on the spot,” as part of the Time Out Project research.
Woodhull Hospital’s Time Out Project, led by Edward Fishkin MD and Minda Aguhob M.Ed., developed this video in Winter 2013 to train staff about how to properly conduct Time Out outside of the operating room. This video is part of a series intended to improve training and implementation of safety checklists throughout Woodhull.
Dr. Farrokh Farrokhi of Virginia Mason Medical Center in Seattle explains why he, a neurosurgeon, finds Time Out — or pre-surgical safety checklists designed to check correct patient, procedure, side, etc. — very useful. He is being interviewed by myself, Minda Aguhob, MEd, in front of my poster on the Time Out project at the 2012 Institute for Healthcare Improvement National Forum.
We discussed the value of “Time Out” pre-procedure safety checklists, as a way for the surgeon to effectively manage the surgical team in the OR. We even talk about it as a practice that develops empathy and soothing of strong emotions – characteristics associated with great doctors.
Dr. Farrokhi and myself met while presenting posters at the 2012 IHI National Forum storyboard session. Hisand Dr. Allison Porter’s poster discusses adaptation of safety checklists to local culture in the OR, and my poster with Drs. Edward Fishkin and Saida Karimova presented baseline Time Out performance data in the OR, ICU, GI Clinic and ER. We will test training techniques at Woodhull this year, such as “on-the-spot” training videos, or simulations, in the OR and medicine floors to learn what helps improve Time Out more effectively.
The Time Out Project’s Dec 2012 IHI Poster was set up under the “Innovate” section at the IHI National Forum 2012 poster session: IHI Storyboards (requires login) http://app.ihi.org/events/viewposterboard.aspx?EventId=2206