Ready to take-off for surgery: New protocol ensures safety

Anesthesia concerns? Check. Surgeon’s concerns? Check. Nursing concerns? Check. “Okay, we all agree, we’re ready for surgery.”

Sound familiar? This checkpoint surgical procedure, part of the new Surgical Patient Safety Protocol at The Montreal Children’s Hospital, is based on the safety processes developed by the aviation industry, consisting of checklists and guidelines. Pilots never begin a flight until all safety measures have been tested, and now surgeons won’t begin a procedure until the safeguard measures of the new Surgical Safety Protocol are verified.

The first step of the Protocol, called “Sign-In”, enables communication between the family and the healthcare team. A checklist, identifying the surgical site and addressing any family questions, must be completed and signed by the surgeon on the day of surgery.

“Time-Out” is the final verification process before the surgery begins. During this time the healthcare team has the opportunity to voice concerns or review things that are not clear.

“Sign-out” is the final phase of the Protocol, where the entire surgical team debriefs and expresses any concerns. Once again, a checklist is completed and issues such as instrument count, specimen labeling, and the recovery procedure are addressed.

The Surgical Patient Safety Protocol was launched in December 2009 and according to nurse manager Linda Sand, is now implemented in 99 percent of surgeries. Although similar safety procedures have been previously used, the new safety protocol is the first to be formally implemented throughout the MCH.

“The goal of the new protocol is to improve communication between the nursing, anesthesia and surgery teams,” says Ms. Sand. “We are aiming to increase the consistency in surgical care communication thereby reducing the risk of preventable complications and provide better and safer care for our patients.”

Did you know?

• The MCH performs about 6500 surgeries/year.

• MCH surgeries range from routine procedures such as hernia repair to complex neurosurgical interventions.

• On average, 10 healthcare professionals are present during a surgery. They include the surgeon, an anesthesiologist, a respiratory therapist, a scrub and circulating nurse.