• Jt Comm J Qual Patient Saf · Jun 2011

    A survey of the use of time-out protocols in emergency medicine.

    • John J Kelly, Heather Farley, Christi O'Cain, Robert I Broida, Kevin Klauer, Drew C Fuller, Helmut Meisl, Michael P Phelan, Elaine Thallner, and Jesse M Pines.
    • Department of Emergency Medicine, Albert Einstein Medical Center, Jefferson Medical College, Philadelphia, USA. KELLYJ@einstein.edu
    • Jt Comm J Qual Patient Saf. 2011 Jun 1;37(6):285-8.

    BackgroundTime-outs, as one of the elements of the Joint Commission Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery has been in effect since July 1, 2004. Time-outs are required by The Joint Commission for all hospital procedures regardless of location, including emergency departments (EDs). Attitudes about ED time-outs were assessed for a sample of senior emergency physicians serving in leadership roles for a national professional society.MethodsA survey questionnaire was administered to members of the American College of Emergency Physicians (ACEP) Council at the October 2009 ACEP Council meeting on the use of time-outs in the ED. A total of 225 (72%) of the 331 councilors present filled out the survey.ResultsTwenty-nine (13%) of respondents were unaware of a formal time-out policy in their ED, 79 (35%) reported that ED time-outs were warranted, and 5 (2%) reported they knew of an instance where a time-out may have prevented an error. Chest tubes (167 respondents [74%]) and the use of sedation (142 respondents [63%]) were most commonly identified as ED procedures that necessitated a time-out. Episodes of any wrong-site error in their EDs were reported by 16 (7%) of the respondents. Wrong patient (9 respondents [4%]) and wrong procedure (2 respondents [1%]) errors were less common.ConclusionsAlthough the time-out requirement has been in effect since 2004, more than 1 in 10 of ED physicians in this sample ofED physician leaders were unaware of it. According to the respondents, medical errors preventable by time-outs were rare; however, time-outs may be useful for certain procedures, particularly when there is a risk of wrong-site, wrong-patient, or wrong-procedure medical errors.

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