Properly identifying a patient for every interaction and planned procedure a is an extremely important first step in any type of medical procedure.   Patients must  be properly identified at every level of care– prior to a physician’s office visit for a routine appointment, to a complex and potentially life-saving  surgery–and every step  in order to deliver medical care that is safe.   IOM identifies  ‘Safety’ as its first quality aim; and proper patient identification is a key  aspect of safe care. After all, no patient wants to have their blood collected and labeled incorrectly that results in a diagnosis or treatment  decision based upon another individual’s test results. No patient wants a procedure or surgery they did not need.

An important way to ensure proper patient identification is by using a procedure called a  ‘time out.’  A time out is used before a procedure or surgery, in which every medical professional and department involved in the procedure verifies that the correct patient is present, the name of the procedure to be performed on the  patient and why it is being performed, along with other relevant procedure information. This “time out” allows everyone to be on the same page and make sure they will be  doing the right thing for the patient.

For the ‘time out’ to be successful, every involved department should participate before the procedure begins. For example, in a bone marrow biopsy procedure, a provider performing the biopsy is present, a nurse or nursing assistant is present, and a laboratory professional is present. If the physician begins the biopsy before the laboratory professional is present, he or she misses the time out and does not get confirmation that they will be preparing  bone marrow smears for the correct patient. Many hospitals perform multiple bone marrow biopsies in a single day. If all involved departments are not present for the time out,  slides could be labeled with incorrect patient information. This is an example of an unsafe situation that could result in an incorrect diagnosis, inappropriate  treatment or the need to repeat the bone marrow procedure.

If the laboratory professional is left out of a “time out” before a bone marrow biopsy, the best course of action is to explain to nursing and providers the importance of the laboratory professional being present before beginning the procedure.  Since the laboratory is often not as close to a patient’s floor as the nursing and physician staff, making a request to be notified via telephone as soon as the bone marrow is scheduled and with adequate time for the laboratory professional to be present for the ‘time out’ is a first step.  Describing the rationale–to ensure proper patient identification on the bone marrow specimen–is critical information to share when making these types of requests.

Laboratory professionals are members of the heath care team, it is important that we fully participate in team events, such as the ‘time out’ procedure used prior to bone marrow collection.