005: Surgical Time Outs To Reduce Operative Errors
In Episode 7, Dr. Kirk discusses the critical topic of preventing wrong tooth extractions during oral surgery. He shares how implementing structured “time outs” has helped avoid these devastating errors in his own practice.
The Wrong Tooth Experience
Russell opens by admitting he has extracted the wrong tooth before, as have colleagues he’s spoken to. He describes the sinking feeling when you realize an error occurred despite best intentions. Russell explains how reconstructing the process after the fact enabled him to strengthen his protocols.
Strategies to Avoid Errors
Russell outlines the specific strategies he uses to prevent wrong tooth extractions:
- Confirm in advance which tooth/teeth the patient expects extracted. Have them point or verify.
- Empower staff to stop you anytime something seems amiss. Agree on a stop signal.
- Review x-rays, referrals, and consents to ensure the planned extractions match.
- Implement a “surgical time out” before starting any procedure, similar to hospitals.
The Surgical Time Out
Russell details the step-by-step process for his oral surgery time out:
- Verify consent form is signed by patient and surgeon before starting.
- Stop all activity and confirm key details verbally:
- Patient name and age
- Planned procedure
- Any drug allergies
- Referring doctor (if applicable)
- Gain verbal agreement from patient and/or clinical team before proceeding.
- Address any discrepancies raised before moving forward with surgery.
Russell notes that patients appreciate these safety steps once the reason is explained. For sedated patients, the time out allows staff one final check before proceeding.
The time out process ensures all team members are on the same page with the surgery plan. Anyone who is uncomfortable can stop the procedure until addressed.
Conclusion
Russell will share a printable surgical time out resource HERE that listeners can use. He welcomes any other ideas around strengthening protocols to prevent errors. Email feedback to [email protected]. Russell thanks listeners and looks forward to the next episode.
