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To reduce the number of wrong-site surgeries in the United States, The Joint Commission's National Patient Safety Goals (2012) include the mandate that all operative sites be marked prior to surgery. The operating surgeon is required to make the site marking in the preoperative area just before the patient is taken in to the operating room. You are the COO of a small town hospital, Center City Memorial Hospital with 32 beds. Your background is in finance and you have and MBA with no clinical experience. Dr. Josephine Roberts is the Chief of the Medical Staff, Dr. Harvey Rehnquist is the Chief of Surgery, and Dr. Townes is a busy general surgeon who does many surgeries. Dr. Townes has been resistant to marking his patients. There have been arguments between Dr. Townes and the operating room (OR) nurses in the past, which has been handled by Dr. Roberts, Chief of the Medical Staff. The OR nurses have been instructed not to bring patients in to the OR until have are properly marked. Despite site marking being The Joint Commission mandate, Dr. Townes refuses to mark the site and states it is detrimental to the patient's well-being and invades the patient's privacy being so close to the patient's genital area. As COO, you have been called upon to resolve this issue on the spot as both clinical Chiefs are at a professional development conference that week. You decide that if the surgical site is not marked, then Dr. Townes would have to explain this to the patient and have the patient sign a release agreeing not to have the site marked and acknowledgement that omitting the marking may cause more risk for wrong-site surgery. After considering this option, Dr. Townes decides the consent procedure is more bothersome than just marking the site. Modified from: Buchbinder, S., Shanks, N., & Buchbinder, D. (2014). Improving Block Time Utilization to Increase Operating Room Efficiency. Cases in health care management, (pp. 93-95). Sudbury, Mass.: Jo
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