Convenience

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Part 4:
Leading
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brief two-minute “team meetings” a regular step in sur-
gical procedure at Johns Hopkins and other university
hospitals. During the meeting, which is conducted just
after anesthesia is administered, all members of the OR
team state their names and roles and the surgeon verifies
the critical aspects of the procedure, including the cor-
rect site.
Where the policy has been adopted, according to
Makary, researchers have observed an increase in “the
awareness of OR personnel with regard to the site and
procedure and their perceptions of operating room
safety.” Without such a policy, Makary points out,
many surgeons simply walk into the OR and start oper-
ating without even asking the names of the other med-
ical personnel in the room. Such measures as team
meetings hold some promise in the effort to reduce
surgical error, as do checklists and time-outs, both of
which require periodic confirmation of the critical
components of a procedure. But “the unfortunate
truth,” cautions Dr. Mark R. Chassin, president of the
Joint Commission, “is that no hospital today … can
guarantee that [surgical errors] will never happen. We
do not know how to perfect our processes….” In some
hospitals, he admits, the Commission has even encoun-
tered “denial or serious avoidance of the potential for
real problems,” and he recommends that patients
everywhere ask surgeons in advance what steps will
be taken to prevent errors while they’re in the OR.
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