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Surgical objects, barcodes and top-down medical culture

How in the world can surgical teams leave objects (such as sponges) behind in patients' bodies?

The question has been a source of consternation for years - and is still a pressing problem.

To be sure, the movement toward the use of surgical checklists has finally begun to address the problem more systemically. After all, such checklists force surgical teams to count the objects that they put in. This number then provides an important reminder of how many items need to come out.

In this post, we will take note of another way to try to solve the problem of what the medical community calls "retained foreign objects": by putting barcodes on the foreign objects and using electronic counters to tally them up.

These counters are supposed to be able to decipher the barcodes even if sponges or other objects are soaked in blood.

So far, the number of hospitals and other healthcare providers using this new, technology-driven approach is relatively small. There about three dozen places around the country that have invested in the technology necessary to use barcodes to detect left-behind surgical objects.

Though the goal of the barcode method is laudable, it is all too easy to try to depend on a technological fix to problems. What may really be needed is a paradigm shift in the way medical services are delivered in the first place.

All too often, surgical errors and other medical mistakes result from a top-down culture that discourages rank-and-file workers from speaking up about safety concerns.

Source: Bloomberg Businessweek, "Can Technology Stop Surgeons From Leaving Sponges Inside Patients?" John Tozzi, March 25, 2014

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