What to Ask About Heart Surgery Safety

Standardizing procedures helps ensure consistent care

Photo courtesy of Cleveland Clinic.org

Patient safety is a major concern in any hospital setting and in cardiac and vascular surgery it mandates every action we take, every day. We use very specific and standardized rules to ensure that patients receive the correct treatments and procedures and that they have the best outcome possible.

Details matter

If you are going to have heart surgery, you should ask about the hospital’s safety procedures and checklists. Doctors and nurses should be asking you questions, taking your medical history and helping you get safely into and out of the OR, through recovery and ultimately, back home.

Before any surgery, staff should check and double check seemingly ordinary details, such as your name and the type of surgery you are scheduled to have and make sure there have not been any medical changes since the last time you saw your medical team (even if it was the day before!). Different members of the medical team may ask you many questions. Sometimes, different people might repeat the same question.

Checklists

We ensure patient safety by using checklists for our surgical procedures. These checklists cover a patient from the minute he or she enters the hospital, into the operating room, all the way through the end of surgery. If the staff follows these checklists, it means the team is doing everything possible to ensure the safety of the patient.

Huddle

The team huddle is an integral step performed before the start of surgery – it makes sure everyone knows the plan and all questions are answered.

• The surgeon describes the operative plan, any special instruments that are needed and any concerns he or she has.
• The nurses verify all correct documentation and make sure they are prepared.
• The anesthesiologist discusses the plan and any concerns he or she may have for surgery.
• The perfusionist discusses the heart bypass machine and plans related to perfusion during surgery.

Just before the surgery begins, a time-out occurs. Time-outs ensure the correct patient is there, the correct procedure is planned, and everything is in place to start the surgery. Then at the end of surgery, the sign-out occurs – a time to make sure that all is complete and everyone is knowledgeable about the status of the patient.

Team routine (The team is key!)

In cardiac and thoracic surgery, routine and repetition are good. We work with the same team every day and this is very important. For the teams to function well, teams need to know each other well.

I have a team of circulating RNs, scrub RNs, perfusionists and operative assistants with whom I work routinely. We establish a bond and a comfort level working with each other. People decide what teams they want to work with and that builds cohesiveness and respect. Each team member needs to feel confident that he or she can speak up with any questions or concerns, which improves patient safety. Ask your surgeon how he selects his team and how long the team has worked together.

Get informed

The thought of having heart surgery can be scary, but knowing that you have an experienced surgeon and surgical team who follow safety standards and checklists can put your mind at ease. Don’t be afraid to ask questions to find out about how they will be taking care of you.

— Joseph F. Sabik III, MD / Cleveland Clinic.org