Making the Surgical Safety Checklist Even Safer: A Team Timeout Checklist to Improve Information Exchange and Interprofessional Communication Before Skin Incision
Authors' conclusion
In our study, the nurse-led TTOC significantly improved the exchange of safety-critical items during the pre-incision phase, facilitated closed-loop communication, and empowered the participation of various professional groups.
Study context
- Population
- Surgical teams in the OR, pre-incision phase
- Participants
- 155 teams
- Exposure
- Nurse-led 16-item team timeout checklist vs no team timeout checklist (TTOC) before skin incision
- Pre-interventionn = 78reference
- Post-interventionn = 77
- Outcome
- Information exchange of checklist items (% of the 16 items verbally communicated among team members)
Methodological detailslive-coded on-site observations, 13,127 coded communication events
- Live-coded on-site observations
- 13,127 coded communication events
Main finding
As reported in the abstract
Information exchange
P < 0.001
Observational data: associations, not effects.
Further findings
Mean
| Outcome | Pre-intervention | Post-intervention | P value |
|---|---|---|---|
| Closed-loop communication patterns per operation | 16.4 (SD 7.24) | 20.4 (SD 10.7) | P = 0.004 |
Information exchange per subitem
- Odds of exchanging information significantly higher after TTOC for 15 of 16 subitems (ORs range; all 95% CIs excluded 1)
- 10.8-1896
Participation rates of professional groups
- Increased for circulating nurses, scrub nurses, surgical residents and anesthesia (all P < .05) but not for lead surgeons
Original publication
Making the Surgical Safety Checklist Even Safer: A Team Timeout Checklist to Improve Information Exchange and Interprofessional Communication Before Skin Incision. Anesth Analg. Published 20 July 2026. doi:10.
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