We follow a screening checklist for all procedures performed in ambulatory surgical centers.

We participate in training and exercises to improve teamwork and communication within the perioperative and ambulatory surgical care settings.

We institute and enforce a policy regarding the presence of healthcare industry representatives and/or observers.

We utilize a pre-operative checklist covering such areas as patient identification, informed consent, current history and physical, site/side marking, review of diagnostic test results and administration of pre-operative medications.

We require that anesthesia providers complete a pre-operative equipment safety checklist.

We follow a protocol for managing unexpectedly difficult intubations and/or airway emergencies.

We require staff to document critical information – such as pre- and post-surgery skin assessments; skin preparation; patient positioning; and use of any padding, supports or restraints – in a specific section of the perioperative record.

We implement the Universal Protocol, which includes a pre-operative verification process, operative site marking and a final time-out.

We implement the same assessments, treatment and monitoring protocols wherever anesthesia is administered, including locations other than the operating room.

We follow industry standards for labeling medicines in syringes, cups and basins.

We have emergency medications readily available and properly secured on the unit.

We have a departmental chain of command, and we are accountable to use it.

We comply with industry guidelines for the prevention and detection of unintended retained foreign objects.

We have a surgical fire prevention and response program in place, which includes staff training and the performance of drills on a regular basis.

We have a protocol addressing clinical alarm management in the perioperative setting, which ensures that alarms remain on, are audible at all times, and undergo preventive and routine maintenance.

We follow protocols for the assessment and management of patients with sleep apnea.

We have a malignant hyperthermia rapid response protocol.

We require all providers to comply with an established process for obtaining approval of new technology or revised procedures.

We train staff and verify their ability to safely use all relevant equipment and technology.

We have specific equipment sterilization guidelines, and regularly monitor staff compliance.

We follow an established process for credentialing physicians who perform laparoscopic or robotic procedures.

We comply with manufacturer guidelines regarding the use of equipment with bariatric patients.

We utilize established perioperative quality metrics, and confirm that they are consistent with industry standards.

We monitor for compliance with established perioperative protocols, guidelines, and policies and procedures.

We have multidisciplinary perioperative patient safety meetings to evaluate trends and opportunities for improvement.

We perform RCA on sentinel and/or serious reportable events.