Wyatt 1b

Wrong Site Surgery: The myths, the realities, the solutions J. Robert Wyatt, MD, MBA Otolaryngology – Head & Neck Surgery Baylor Health System Dallas, Texas Glenn Rothman, MD Chairman, Department of Surgery Head & Neck Oncology Banner Desert Medical Center Mesa, Arizona

Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Surgeon background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Your surgeon makes errors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Fundamentals of errors Stop, teach decision making skills Faulty strategy to solve problem Unfamiliar situation, no rule, problem solving task Knowledge-based errors Educate, critical thinking, accountability Wrong rule, misapplication of correct rule, non-compliant with rule Act requiring application of rules to familiar event Rule-based errors Pay attention Slips, lapses Familiar act, little attention Skill-based errors Prevention Example Description Error Type

Learning from the experts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Wrong site surgery: The frequency debate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Impact of wrong site cases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Joint Commission mandate ,[object Object],[object Object],[object Object],[object Object],[object Object]

Has JCAHO solved wrong site? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Factors contributing to failures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 1: Correct and incorrect sites both marked ,[object Object],[object Object],[object Object],[object Object]

Case 2: Wrong site marked ,[object Object],[object Object],[object Object],[object Object]

Case 3: Imprecise site mark ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 4: Authorship of site mark unclear ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 5: Site mark washed off ,[object Object],[object Object],[object Object]

A new solution… ,[object Object],[object Object],[object Object]

The solution: Key requirements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stamp benefits: Consistency ,[object Object],[object Object]

Stamp benefits: Unambiguous ,[object Object],[object Object],[object Object]

Stamp benefits: Withstanding the prep ,[object Object],[object Object],[object Object]

Stamp benefits: Reduced infection risk ,[object Object],[object Object],[object Object],[object Object]

Stamp benefits: Reduced complexity ,[object Object],[object Object],[object Object]

JCAHO requirements ,[object Object],[object Object]

Case 1: Correct and incorrect sites both marked ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 2: Wrong site marked ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 3: Imprecise site mark ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 4: Authorship of site mark unclear ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 5: Site mark washed off ,[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object]

Wyatt 1b

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Wyatt 1b