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Study: Decreasing Wrong-Site Surgery

A study conducted by the Johns Hopkins Center for Surgical Outcomes Research concluded that hospital policies requiring a brief meeting of hospital staff members involved in a procedure before operations begin could decrease wrong-site surgeries and other errors.

“Although we lack systems for uniform reporting of wrong-site surgeries to understand the extent of the problem, we observed team meetings increase the awareness of OR (operating room) personnel with regard to the site and procedure and their perceptions of operating rooms safety,” said Martin Makary, M.D. M.P.H., head author of the study, which will appear in the Journal of the American College of Surgeons February issue.

The Problem

Last year, a study in the Archives of Surgery looked at 2.8 million operations over a 20-year period in Massachusetts suggested that a wrong-site surgery occurs in about one out of every 112,994 surgeries, not including surgeries that were performed on the wrong part of the spine.

The study excluded the spine because it is only one body part, and the definition of “wrong-site surgery” used in the study specified that to be considered wrong-site, the surgery must have been performed on the wrong organ or body part entirely.

“The Joint Commission identified communication breakdowns as the most common root cause of wrong-site surgeries,” said Makary.

The Solution

The Joint Commission, evaluators and accreditors of nearly 15,000 health care programs and organizations, now requires staff to have meetings before each surgery in the OR.

Makary has championed efforts at Hopkins to enforce the standardized OR briefing program that became standard policy in June 2006. He has since been working with Rochester University, Columbia, Cornell, Yale, and the world health organization to implement the same program in more facilities.

The Meetings

The brief meetings, held in ORs just after anesthesia is administered, are two minutes long. In them, each of the staff members involved in the surgery will state their names and the role they will play in the operation. The lead surgeon will also verify the patient’s identity, the surgical site, and other critical information about the procedure.

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