Getting ready to perform an invasive or risky procedure? Consider taking a “time out,” a tool that allows you and your staff to take a breather to make sure everyone is on the same page and your documentation is completed.
Posted in Risk Management on Monday, February 21, 2022
Outside of your practice, you’ve likely seen and even participated in a time out as you’ve been taxiing on an airplane runway:
Verbal Agreement Example
Before takeoff, a flight attendant addresses the people seated in the emergency exit row and asks them questions about their ability and willingness to assist passengers off of the plane if necessary. The answer to these questions must be verbal – a nod or head shake will not suffice.
If you’ve been seated in the emergency exit row, then you have unwittingly participated in a risk management/safety step to confirm that the passengers were truly paying attention and understand what is being asked of them. Health care and aviation are not dissimilar when it comes to best practices for safety. So what can this airline practice teach us when it comes to dental surgery and procedures?
A Real-Life Scenario
A dentist recently found herself faced with a staff shortage. Temporary staff, employed by an independent third-party company, were brought in to assist. The dentist was relying on the staff to have all the tools and materials needed for a procedure readily available. However, during the “time out” before the procedure commenced, she discovered that the specific supplies had not been obtained and were not readily available, potentially affecting the results and efficiency of the procedure.
Does "Time Out" Apply to Dentists?
You have probably heard of a “time out” and may question its use in a dental setting. However, the Joint Commission recommends a time out be performed prior to any invasive or irreversible treatment. As reference, an invasive procedure is defined as one that involves a puncture, an incision or the insertion of foreign material that exposes the patient to more than minimal risk. The time out is a chance to take a breather to communicate with staff, decrease risk, and better ensure patient safety.
Time out checklists can vary depending on your area of expertise and institution, but the basics remain the same:
Pre-Procedure Steps
- Verify the patient, procedure and site
- Involve the patient in the confirmation when possible
- Identify tools, supplies and other necessities for the procedure
- Review safety precautions based on the patient history
Electronic Health Records
In some cases, you may be able to record that a time out was completed using your Electronic Health Record (EHR). If your EHR doesn't have this capability, consider an additional step to the time out process that allows you to confirm that you have received everything you needed. You should also add a line to document that your staff verbally confirmed that they reviewed and supplied everything requested.