Running the Checklist From Start to Finish

In practice

The case is a laparoscopic gallbladder removal. Before induction, the circulating nurse leads the first pause with the anesthesia provider: the patient states their name, date of birth, the procedure and the side, and confirms consent. The patient has no allergies. Anesthesia confirms its safety check, the pulse oximeter, and no difficult airway. The expected blood loss is small. Meanwhile, Jules, the scrub person, completes the setup and the initial count. Before incision, the whole team stops for the time out. Everyone introduces themself, including a student observing. The circulating nurse reads the procedure from the consent, and the surgeon, anesthesia provider and circulator each confirm. The anesthesia provider confirms the antibiotic was given within the protocol window. The surgeon says this is a routine case, expected to take about an hour, with little blood loss. The anesthesia provider has no special concerns. Jules says that sterility was verified, all indicators passed, the laparoscopy equipment was tested, and there are no special concerns. Imaging is not needed. At the end of the case, during closure, the circulator leads the final pause: the procedure performed is confirmed, Jules and the circulator confirm the counts are complete and correct, the gallbladder specimen label is read aloud with the patient's name, no equipment problems are reported, and the surgeon and anesthesia provider review the plan for recovery.