What is your OR Time OUT consist of??

We have two; one as the patient enters the room, before induction with attending, anesthesia, Circulator and tech all involved in the pre-induction time out----and most patients, if they aren't too groggy with anesthesia induction agents.....the patient is ID'ed by name, Birthdate, Med Rec, surgeon, site/type of surgery, allergeries, antibiotics ordered, position, blood in room, implants or special equipment needed?
Then prior to incision, we have another time out, again involving the entire OR team. This time we confirm surgery, side, antibiotics going in, prep is dry, position, and implants present.
At the end of the case, we are required to make sure that the posted CPT codes are the correct ones, how many specimens, and where our patient is going post op.

Now, we started this late last year, when JACHO said our time outs were not good enough. We put this script into place, audited outselves, changed what is put on the white boards in the room, etc.

About three weeks ago, two of us were getting ready as fast as we could for a liver transplant. We had hardly opened when the patient came into the room, lines went in very quickly and suddenly- everyone but the OR team was ready for incision. We said, we haven't counted, please wait to scrub. And the wonderful surgeon, bless him, waited for us to give him to go ahead, because he knew that if he was scrubbed, he'd be draping, etc, and that couldn't have worked at all well.

Then we did our second time out and got started; counted, pt identified properly, everything we needed there, etc.

I think the time outs at my facility are a happy medium. We cover some pertinent info (pt. name, surgeon, procedure, side if applicable, allergies, antibiotics received) but not too much. We also state that the consent, schedule, H&P, orders and pt. interview all agree. My only pet peeve is that some surgeons do tend to want to carry on with their own conversations and not stop and listen to the time-out. My tactic so far has just been to keep repeating "time out" in a progressively louder voice until I have their attention. But I really like the "I'm not wearing a bra today" line, so I think I'm gonna steal it.

When we were tasked with our new format of JACHO's mandate, it was made very plain to the attendings, residents, med students, OR staff, and anesthesia, that everyone was quiet and paying attention-or the time out didn't go forward. It's funny how quickly EVERYONE became compliant when reminded that if JACHO was unhappy with our time outs, that they could pull our credentials and shut us off, period. THAT made it through their thick heads!

And actually, it hasn't really changed anything as far as I can tell. I hope that the intended effect, which is to reduce wrong side, wrong person, etc, comes to pass. I really hope that those types of errors decrease substantially with this type of time out system.