Why isn't 'time out' being implemented? An exploratory study

View/ Open
Author(s)
Gillespie, Brigid M
Chaboyer, Wendy
Wallis, Marianne
Fenwick, Clare
Year published
2010
Metadata
Show full item recordAbstract
Background While there has been much discussion extolling the virtues of using 'time out' as a means of preventing the potential for sentinel events, to date there has been little examination of the issues that impact on clinicians' uptake of 'time out' in operating-room settings. Aim This study sought to methodically identify implementation and practice issues associated with the introduction and ongoing use of a 'time out' protocol in a large healthcare organisation. Methods Sixteen participants were interviewed and included surgeons, anaesthetists, nurse managers and nurses who worked at the clinical interface. ...
View more >Background While there has been much discussion extolling the virtues of using 'time out' as a means of preventing the potential for sentinel events, to date there has been little examination of the issues that impact on clinicians' uptake of 'time out' in operating-room settings. Aim This study sought to methodically identify implementation and practice issues associated with the introduction and ongoing use of a 'time out' protocol in a large healthcare organisation. Methods Sixteen participants were interviewed and included surgeons, anaesthetists, nurse managers and nurses who worked at the clinical interface. Textual data were analysed using a grounded theory approach, identifying subcategories to illustrate causal relationships to the category. Results The category 'ambivalent compliance with "time out"' was the central idea that was recognised by events and behaviours that surrounded the introduction of 'time out.' Subcategories included haphazard implementation of time out, hierarchical team culture and tribal affiliations of members, and clashing clinical priorities make it difficult to incorporate 'time out' into practice, and led to 'ambivalent compliance.' Conclusion There is little doubt that using a 'time out' protocol in the operating room allows team members to share explicit confirmation of safety-related details. However, when introducing patient safety initiatives into practice, recognising compliance issues is an important first step towards identifying ways in which to address them.
View less >
View more >Background While there has been much discussion extolling the virtues of using 'time out' as a means of preventing the potential for sentinel events, to date there has been little examination of the issues that impact on clinicians' uptake of 'time out' in operating-room settings. Aim This study sought to methodically identify implementation and practice issues associated with the introduction and ongoing use of a 'time out' protocol in a large healthcare organisation. Methods Sixteen participants were interviewed and included surgeons, anaesthetists, nurse managers and nurses who worked at the clinical interface. Textual data were analysed using a grounded theory approach, identifying subcategories to illustrate causal relationships to the category. Results The category 'ambivalent compliance with "time out"' was the central idea that was recognised by events and behaviours that surrounded the introduction of 'time out.' Subcategories included haphazard implementation of time out, hierarchical team culture and tribal affiliations of members, and clashing clinical priorities make it difficult to incorporate 'time out' into practice, and led to 'ambivalent compliance.' Conclusion There is little doubt that using a 'time out' protocol in the operating room allows team members to share explicit confirmation of safety-related details. However, when introducing patient safety initiatives into practice, recognising compliance issues is an important first step towards identifying ways in which to address them.
View less >
Journal Title
Quality and Safety in Health Care
Volume
19
Copyright Statement
© The Author(s) 2010. The attached file is reproduced here in accordance with the copyright policy of the publisher. For information about this journal please refer to the journal's website or contact the authors.
Subject
Clinical sciences
Acute care
Curriculum and pedagogy