Theatre

A case does not pass a check that is not complete

There is no going into theatre without the sign in, no incision without the time out, and no closing without the sign out. The check happens when you press the button, not when the screen loaded, so a checklist somebody was still filling in a moment ago does not let the case through.

A half-answered check is not a completed one

Every item has to be answered. Whether a check is complete is worked out from the answers rather than taken from a box somebody ticked at the top.

The sign out needs its counts

Both counts are required: correct, not correct, or not applicable when nothing of that kind was counted in. A count that is not correct requires a note saying what was missing and what was done. A retained swab is found by somebody reading that note.

Each part of the record is signed by the person whose part it is

The operative record is signed by the surgeon this case names and the anaesthetic record by the anaesthetist who gave it. A surgeon cannot sign the anaesthetic record however senior they are, because the person who gave the anaesthetic is the only one who can attest to it.

A signed section cannot be changed

A correction is an addendum that says what it corrects and why. That is what makes the original still readable a year later, which is what a record is for.

The patient is on every screen

The list, the case and every check name the patient with their date of birth and record number, and the case and checks show their recorded allergies and the site. The time out asks the team to agree the patient, the procedure and the site, so all three are in front of them.

A step is confirmed before it is recorded

Moving a case on asks you to confirm, because a case never goes backwards, and the button is held while the step is recorded so a second press cannot move it twice.

This does not take consent

It records that consent was taken and by whom, with a reference somebody can find. It is not the consent form.

Two cases in one theatre are not refused

The list shows the day so you can see the clash. A double booking is caught in the morning huddle; operating without a time out is not, which is where the refusals are.

A theatre that is not set up yet

While booking a case, somebody who manages departments and beds can choose Add theatre at the foot of the theatre list. The case you were booking stays as you left it, and the new theatre comes back chosen.

Book a case

1. Choose the theatre at the top to see its list. It opens on the one you chose last time on this device, or asks. Somebody else signing in on the same computer does not get your choice.
2. Select Book a case. The theatre whose list is open is shown at the top of the form; change it there to book into another. Then find the patient by name, mobile or record number, and give the procedure and the side.
3. Choose how urgent it is, then choose the surgeon from the doctors on the team, because that is whose signature the operative record will require.

Run the checks

1. Open the case and run the sign in before it goes into theatre.
2. Run the time out before incision, with everybody present.
3. Run the sign out, with both counts, before the case is closed.

Write the record

1. Select Write a section and choose which part of the record it is. A part only the named surgeon or anaesthetist can sign is greyed out for everybody else, with who signs it.
2. Write it and sign it in one act. There is no draft somebody else finishes.
3. To correct something already signed, write an addendum that says what it corrects.