OHSU

Team Pause

OHSU and our department take this activity very seriously, so please adopt this practice. The "team pause" is one part of the hospital "Correct Site Universal Protocol", which addresses pre-procedure verification and site marking in addition to the team pause.

The radiologist is responsible for leading/initiating the team pause in a "fail-safe" mode (all participants are focusing on the pause) and should assure that all members of the team that will be involved in the procedure are in the room during the team pause.

The RN or technologist involved in the procedure is responsible for stopping the procedure if they do not feel the team pause was properly executed. The RN or technologist is also responsible for documenting the team pause.

Some procedures performed outside the OR are exempt from the team pause as long as there is no anesthesia or sedation involved. Please check with your section chief as to required or exempt procedures.

Below is team pause information from the hospital policy with highlighting of information that speaks to the provider's role.  

Team Pause Prior to the Start of the Procedure

This is the final verification that the correct patient, site, procedure, positioning are identified appropriately, and agreed upon and, as applicable, all relevant documents, related information and necessary equipment are available. The Team Pause will be conducted in the location where the procedure will be performed prior to starting the procedure. 

The Circulating Nurse or equivalent personnel in ambulatory, ancillary, inpatient areas when included in the procedure will be the final gatekeeper for ensuring that: the Team Pause takes place in a fail-safe mode all members participate the Team Pause is complete, and all required elements are documented in the integrated health record. This person has the authority to prevent the procedure from starting until the Team Pause is properly executed. This person has the responsibility to report any variance via Patient Safety Net.

The Team Pause will be conducted in a fail safe environment

1. This is the final verification that the correct patient, site, procedure, positioning are identified appropriately, and agreed upon and, as applicable, all relevant documents, related information and necessary equipment are available.

2. The Team Pause will be conducted in the location where the procedure will be performed prior to starting the procedure.

3. The Team Pause is initiated by the Provider starting the procedure and involves the immediate members of the procedure team (e.g., Proceduralist, Anesthesia Providers, Circulator and Scrub in the Operating Room, the nurse caring for the patient, and other participants as appropriate who will be participating in the procedure at its inception).

4. The Circulating Nurse or equivalent personnel in ambulatory, ancillary, inpatient areas when included in the procedure will be the final gatekeeper for ensuring that:

  • the Team Pause takes place in a fail-safe mode
  • all members participate
  • the Team Pause is complete, and all required elements are documented in the integrated health record. This person has the authority to prevent the procedure from starting until the Team Pause is properly executed. This person has the responsibility to report any variance via Patient Safety Net.

5. The Team Pause will be conducted in a "fail-safe" mode. This means:

  • All activity in the room is suspended to the extent possible without compromising the safety of the patient until the final verification has been done.
  • All members of the team are actively engaged in the Team Pause.
  • The Team Pause involves verbal agreement between all team members.  Any member of the team with concerns or unanswered questions is encouraged to speak up. If there is any discrepancy in the information identified by any member of the surgical team, all discrepancies or disagreements will be resolved before proceeding.

6. The Team Pause includes the following elements which are to be documented in the integrated health record along with the names of Team Pause participants:

  • Correct patient identity (checked against the consent form)
  • Identification of the correct site and side(s) (checked against the consent form)
  • Procedure to be performed (checked against the consent form)
  • Proper patient position
  • Availability of appropriate diagnostic and radiology test results (e.g., radiology images and scans or pathology and biopsy reports) 
  • Relevant images and results are properly labeled and appropriately displayed
  • Need for special medications or fluids for irrigation purposes
  • Administration of prophylactic antibiotics if indicated 
  • Safety precautions based on patient history or medication use.

7. In cases involving multiple procedures or more than one Service, the Team Pause will be repeated at the beginning of a new procedure.