RT Journal Article
SR Electronic
T1 Why isn't ‘time out’ being implemented? An exploratory study
JF Quality and Safety in Health Care
JO Qual Saf Health Care
FD BMJ Publishing Group Ltd
SP 103
OP 106
DO 10.1136/qshc.2008.030593
VO 19
IS 2
A1 Brigid M Gillespie
A1 Wendy Chaboyer
A1 Marianne Wallis
A1 Clare Fenwick
YR 2010
UL http://qualitysafety.bmj.com/content/19/2/103.abstract
AB Background While there has been much discussion extolling the virtues of using ‘time out’ as a means of preventing the potential for sentinel events, to date there has been little examination of the issues that impact on clinicians' uptake of ‘time out’ in operating-room settings.Aim This study sought to methodically identify implementation and practice issues associated with the introduction and ongoing use of a ‘time out’ protocol in a large healthcare organisation.Methods Sixteen participants were interviewed and included surgeons, anaesthetists, nurse managers and nurses who worked at the clinical interface. Textual data were analysed using a grounded theory approach, identifying subcategories to illustrate causal relationships to the category.Results The category ‘ambivalent compliance with “time out”’ was the central idea that was recognised by events and behaviours that surrounded the introduction of ‘time out.’ Subcategories included haphazard implementation of time out, hierarchical team culture and tribal affiliations of members, and clashing clinical priorities make it difficult to incorporate ‘time out’ into practice, and led to ‘ambivalent compliance.’Conclusion There is little doubt that using a ‘time out’ protocol in the operating room allows team members to share explicit confirmation of safety-related details. However, when introducing patient safety initiatives into practice, recognising compliance issues is an important first step towards identifying ways in which to address them.