American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on Ensuring Correct Patient, Correct Site, and Correct Procedure surgery

The following statement was developed by the College's Committee on Processes of Surgical Care and the Member Services Liaison Committee. It was approved by the Board of Regents at its adjourned meeting on October 11, 2002.

The American College of Surgeons (ACS) recognizes patient safety as being an item of the highest priority and strongly urges individual hospitals and health organizations to develop guidelines to ensure correct patient, correct site, and correct procedure surgery. The ACS offers the following guidelines to eliminate wrong site surgery:

  1. Verify that the correct patient is being taken to the operating room. This verification can be made with the patient or the patient's designated representative if the patient is under age or unable to answer for him/herself.
  2. Verify that the correct procedure is on the operating room schedule.
  3. Verify with the patient or the patient's designated representative the procedure that is expected to be performed, as well as the location of the operation.
  4. Confirm the consent form with the patient or the patient's designated representative.
  5. In the case of a bilateral organ, limb, or anatomic site (for example, hernia), the surgeon and patient should agree and the operating surgeon should mark the site prior to giving the patient narcotics, sedation, or anesthesia.
  6. If the patient is scheduled for multiple procedures that will be performed by multiple surgeons, all the items on the checklist must be verified for each procedure that is planned to be performed.
  7. Conduct a final verification process with members of the surgical team to confirm the correct patient, procedure, and surgical site.
  8. Ensure that all relevant records and imaging studies are in the operating room.
  9. If any verification process fails to identify the correct site, all activities should be halted until verification is accurate.
  10. In the event of a life- or limb-threatening situation, not all of these steps may be followed.

The American College of Surgeons offers this statement for consideration by surgeons and their hospitals and health organizations. It must be reviewed and modified as necessary to conform to the laws of the applicable jurisdiction and the circumstances of the individual hospital and health organization.

Reprinted from Bulletin of the American College of Surgeons
Vol.87, No. 12, December 2002