Fundamentals of Management, 8th ed

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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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