RT Journal Article
SR Electronic
T1 Timeout procedure in paediatric surgery: effective tool or lip service? A randomised prospective observational study
JF BMJ Quality & Safety
JO BMJ Qual Saf
FD BMJ Publishing Group Ltd
SP 622
OP 627
DO 10.1136/bmjqs-2020-012001
VO 30
IS 8
A1 Oliver J Muensterer
A1 Hendrik Kreutz
A1 Alicia Poplawski
A1 Jan Goedeke
YR 2021
UL http://qualitysafety.bmj.com/content/30/8/622.abstract
AB Background For over a decade, the preoperative timeout procedure has been implemented in most paediatric surgery units. However, the impact of this intervention has not been systematically studied. This study evaluates whether purposefully introduced errors during the timeout routine are detected and reported by the operating team members.Methods After ethics board approval and informed consent, deliberate errors were randomly and clandestinely introduced into the timeout routine for elective surgical procedures by a paediatric surgery attending. Errors were randomly selected among wrong name, site, side, allergy, intervention, birthdate and gender items. The main outcome measure was how frequent an error was reported by the team and by whom.Results Over the course of 16 months, 1800 operations and timeouts were performed. Errors were randomly introduced in 120 cases (6.7%). Overall, 54% of the errors were reported; the remainder went unnoticed. Errors were pointed out most frequently by anaesthesiologists (64%), followed by nursing staff (28%), residents-in-training (6%) and medical students (1%).Conclusion Errors in the timeout routine go unnoticed by the team in almost half of cases. Therefore, even if preoperative timeout routines are strictly implemented, mistakes may be overlooked. Hence, the timeout procedure in its current form appears unreliable. Future developments may be useful to improve the quality of the surgical timeout and should be studied in detail.The anonymised, non-identifiable data this study is based on are available upon request. Requests should be directed to the corresponding author. Reuse is permitted for scientific purposes and quality initiatives.