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How do we keep patients safe? Let’s count the ways

From instrument counting to timeouts, perioperative teams play a vital role in Asante’s quality.


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Despite the pressures of the pandemic and the accompanying staffing shortages, Asante continues to be one of the top-performing health systems in the country. We earned 15 Top status for the 10th consecutive year, CMS five-star ratings for hospital quality and straight A’s from the Leapfrog Group, an independent organization that monitors patient safety.

Our perioperative departments deserve some of the credit for these achievements. To ensure our patients receive the safest and highest-quality care, surgery protocols involve multiple steps with every procedure. These steps include:

Inspecting supplies and equipment. Every instrument and all supplies are examined for sterility during setup. After they’re opened and set up, the operating suite is never left unattended to ensure a sterile environment.

Counting. Before, during and after each surgery, teams count instruments and supplies. The patient does not leave the OR suite until all instruments and supplies are accounted for.

Timeouts. A timeout is the intentional pause by all members of the surgery or procedure team. Everyone on the team is empowered to provide input when agreeing on the correct patient, surgery and laterality.

Timeouts also include verbal confirmation that all equipment and supplies are present prior to incision, identifying any fire risks, ensuring indicated prophylactic antibiotics have been given, and checking the availability of blood products if applicable.

Sign-outs. Similar to the time out at the beginning of surgery, the sign-out is an intentional pause by all team members at the conclusion of a surgery to verbalize that specimens are labeled correctly, documentation is accurate, and instrument and supply counts are verified.

Sign-outs include documenting use of any immediate-use steam sterilization, and whatever postoperative concerns the team discussed before the patient leaves the OR suite.

Infection prevention

In addition to ensuring a culture of safety, the perioperative teams also take steps to prevent surgical-site infections, a patient safety measure that is reviewed for national safety rankings.

The methods used by all Asante perioperative teams for SSI prevention include:

  • Preoperative MRSA testing and decolonization if indicated.
  • Chlorhexidine bathing the night before and day of surgery.
  • Using nasal iodine for selected surgical procedures.
  • Ensuring normothermia through all phases of surgery and recovery.
  • Keeping surgery site hair removal to a minimum and outside the operating room when possible.
  • Prophylactic antibiotic administration.
  • Using bowel isolation technique for colon surgeries.

Following each of these important safety steps require diligence by all members of the perioperative department. Asante’s higher-than-average patient safety scores are a testament to the dedication of these employees and providers, as well as all staff members who are working to keep our patients safe.

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