Step 1
There is no I in Team
Step 3
It's all in the detail
Step 2
100

Patient is Identified by

what is 2 identifiers: Name and DOB

100
The staff are introduced by their? 
What is their Name and Role 
100

The surgical count is completed and is announced to the surgical team by

What is the Circulator

100

The surgeon is requesting the blade before the time out.

What is to have the scrub tech not pass the blade and inform circulator to start time out. 

100

The circulator states the following in a time out...the patient, procedure, and ____________?

What is side if applicable

200

Procedure is verified with what document? 

What is the Surgical Consent
200

The anesthesia team should be aware of what patient information during the time out?

What is if they are a difficult airway, aspiration risk, any allergies?
200

The circulator confirms what with the surgeon following surgery?

What is the procedure and diagnosis

200

The delays for the surgical case

What is surgeon delay, patient delay, supplies, prior case running longer, etc. 

200

The procedure is verified with surgical consent, site marking, as well as
_____________?

What is images displayed - for example x-rays

300

The side/site of surgery should be? 

What is Marked by the surgeon

300

The anesthesia safety check consists of?

What is the Anesthesia Machine and medication check is complete

300

The circulator and scrub tech verify what is off the back table and labeled correctly?

What is specimens

300
The circulator will confirm with the scrub tech the details of the specimen label which include

What is patient sticker, date, time, specimen name

300
The surgical site is ______________ with markings after draping, reports and physical verification?

What is Visible 

400

The first step of the time out which is done prior to what?

What is Induction of Anesthesia

400

The team members that are part of the time out are?

What is the surgeon, the anesthesia team, circulator, scrub tech, first assist. 

400

The circulator mentions what to the recovery nurse?

What is key concerns, management of patient, what is procedure, dressing, local administered?
400

The combo case have two surgeons and the second surgeon was not present in the first time out

What is perform another time out with team. 

400

The safety concerns for a patient undergoing surgery with a flammable prep?

What is an OR fire

500

The anesthesia time out is initiated by

Who is the circulator

500

The final question following a time out? 

What is Does Everyone Agree? 

500

The medications following surgery are

What is properly secured and wasted/disposed of properly following policy guidelines 

500

The Classic Rock Song just reached the best part of the song during the time out.

What is stop the music before the time out

500

The priority of circulator and scrub tech when prepping and utilizing implant/tissue?

What is document EVERYTHING? Solution, lot number, expiration date, time, date, surgeon