What are the core elements of the Universal Protocol used to prevent wrong-site, wrong-procedure, and wrong-person surgery?

• A. Verification of patient identity, procedure, and site; site marking; and a time-out.
• B. Verification of patient consent only.
• C. A structured anesthesia checklist.
• D. A postoperative handoff procedure.

Answer: (A)

The Universal Protocol uses three safeguards to prevent wrong-site, wrong-procedure, and wrong-person surgery: pre-procedure verification of the patient’s identity, the intended procedure, and the operative site; marking the operative site; and performing a time-out right before the incision with full team participation.

Pre-procedure verification makes sure the patient’s identity, the exact procedure, and the intended site are correct, catching mismatches or miscommunications before any incision. Site marking provides a visible, unambiguous cue to identify the exact location or side to operate on, ideally done with the patient present. The time-out is a final, collective pause where everyone confirms the patient’s identity, the procedure, and the site, along with other critical details, just before skin incision.

This trio directly addresses the key risks of wrong-site and wrong-procedure surgery in a coordinated, team-based way. Other options, such as focusing only on consent, relying on an anesthesia checklist, or handling postoperative handoffs, do not safeguard against all three error types in the moment of surgery.