Check – Mark – Pause!BWH Nurse - For and about the Nursing Staff of Brigham and Women's HospitalCheck – Mark – Pause!BWH Nurse - For and about the Nursing Staff of Brigham and Women's Hospital

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Check – Mark – Pause!

New Patient Safety System Adopted

In our ongoing effort to prevent medical errors, BWH has adopted a universal patient, procedure and site verification policy for all surgical and invasive procedures. The policy helps ensure that there are check systems at each step in the process, and that the correct procedures are performed on the correct patients. All hospitals are now required by JCAHO’s National Patient Safety Goal to observe this policy.

The pre-procedure checklist follows three simple steps: Check, Mark and Pause.
CHECK! – The pre-procedure RN talks with the patient, and confirms with them the following:
• Who they are – their name and date of birth, confirmed with their ID band
• What procedure they are here for, and where it will be (left or right hip, for example)

The RN also checks the patient’s consent for the procedure and their history and physical, and ensures the data is consistent. If it is not, the attending physician is notified and the discrepancy resolved before moving the patient to the procedure area.

MARK! – After verifying everything in the Check stage, an MD or PA team member, with patient participation if possible, marks the site of the procedure. The site marking is performed before the patient is brought to the procedure area. The anesthesia provider also ensures blood availability at this time.
After documentation is corroborated and the site marked, the patient can continue to the procedure area, where the procedure RN confirms the marking, equipment, implants and instrumentation. The MD or PA team member now ensures that any appropriate images
are available and properly visible.

PAUSE! – In this last step, the entire team stops to verbally confirm the patient, the procedure and the site. This team verification, or “Safety Pause,” is recorded in the medical record.

For questions about the patient, procedure and site verification policy, contact Tejal Gandhi, MD, or Erin Graydon-Baker of the Patient Safety Team, or Janet Barnes, RN, JD, of Risk Management.