Limiting medical mistakes

Hartford, Conn. (WTNH) - Just minutes before heading into the operating room to remove a lymphnode in her neck, Toni Hassler undergoes another thorough check. This time from her surgeon.

"What we're going to do is to make an incision on the outer part of your neck," Dr. Scott Ellner explained.

The meeting is the last of a string of medical staff in and out of Hassler's post-op room.

"All the nurses, the doctors, everybody, they went through everything, step by step, three or four times, just to double, triple check," she said.
 
The left side of her neck, the surgical area, is also carefully marked so there is no confusion.   

It's all part of the 'safe surgery checklist' now in place at St. Francis Hospital and Medical Center.

The process is about patient safety.

Dr. Ellner said, "We did our own study here and looked at 75 cases using the checklist and we've found a significant reduction from 21 percent complication rate to down to 6 percent."  
   
The close focus has patients like Hassler, very comfortable with their course of treatment.  

"I think it will be just fine, just a quick simple easy thing to do," she said.
 
Complacency, says Dr. Ellner, is the number one concern.

He adds, "We forget to check namebands, we forget to discuss with the patient that the procedure that is intended is outlined in detail so they are properly informed."

So patients go through four rounds of thorough scrutiny, including two right in the operating room.

Dr. Ellner confirming again, "We're going to do a left surgical neck lymphnode biopsy."

A nurse answers, "Yes, the left side is still marked."
 
Everyone involved has a role to play in the OR. A so-called time out script, complete with questions to be asked is critical to the teamwork approach.

Dr. Ellner says, it comes down to, "Everybody understanding that doing something in a fashion where we are all prepared, we all have the same idea of what to expect."

Just so everyone is on the same page. The last debriefing occurs after surgery is completed and before the patient heads to recovery.

Dr. Ellner speaks up clearly, "Specimen is left neck lymph node? Yes. Lymphoma workup.  Our counts were good.  Our next case we are going to do - a right inguinal hernia."

Meantime, Dr. Ellner is working with state legislators to make the time out script, standard operating procedure in every hospital in the state.