The Joint Commission on Accreditation of Healthcare Organizations issued for public comment a proposed universal protocol for marking surgery sites and verifying the intent of surgical procedures before patients have operations. The aim is to reduce the likelihood of wrong-site, wrong-procedure and wrong-patient surgery with a standardized approach applicable to all operative and invasive procedures. The JCAHO already requires accredited organizations to take consistent measures to prevent such errors, but the "standard" approaches can differ among providers, confusing surgeons and other operating-room professionals who work at several organizations, said JCAHO spokeswoman Charlene Hill. For example, the wrong leg can be marked with a big "NO" but nothing marks the correct leg. Or an X on a leg can be either the sign of a correct site or the wrong site. Proposed guidelines include making an unambiguous mark at or near the incision line, with the marking to be performed by the surgeon doing the procedure.
The universal protocol represents consensus among the American Medical Association, American Hospital Association, American College of Surgeons, American Dental Association and American Academy of Orthopaedic Surgeons. The JCAHO board will review and consider additional comments submitted by July 9 before it takes action to approve the protocol. The JCAHO said it also will seek broad endorsement and support from medical and healthcare associations nationwide. More information is available on the JCAHO's Web site. -- by John Morrissey