A Multidisciplinary Team Approach to Retained Foreign Objects

Retained Foreign Bodies: Risk and Outcomes at the National Level

“…We were not able to identify patients who were diagnosed with RFB on readmissions; however, previous studies showed that the majority of foreign bodies are identified before patient discharge. 17 Current literature review revealed a wide range of policies and protocols that could be implemented to target [2][3][4][5][6][7][10][11][12][13][14][15][16][17][18][19] ; those methods included administrative policies that regulate the operative environment and protocols that ensure an efficient interpersonal communication. [2][3][4][5][6][7][10][11][12][13][14][15][16][17][18][19] Although those methods were successful in decreasing the incidence of RFB, none of them was perfectly immune to unintentionally retained objects, 20 which led to the assumption by some investigators that other risk factors are still unexplored.…”

Root-cause analysis: swatting at mosquitoes versus draining the swamp

“…But, if disguised observation suggests no dereliction of the counting policy, then the policy probably does not work. The hospital needs to consider investing in a new solution, such as more intensive, multifaceted monitoring strategy19 or a technology solution such as radiofrequency identifications20 or other expensive but potentially worthwhile solutions 18…”

Retained surgical sponges, needles and instruments

“…Concerned as an organisation and aiming to reduce RSI incidents to zero, the Mayo Clinic instituted a multidisciplinary, multiphase managerial approach in 2005 27 . They implemented key initiatives (performing defect analysis and policy review), initiated awareness, enhanced communication, and formed a rapid response events leadership team to monitor and control any RSI event.…”

“…In the 18-month period following the implementation of the new RSI risk reduction strategy, not a single sponge was reported retained, with a negligible increase in overall operating times, a short learning curve and good acceptance among staff members. This was a considerable feat for an organisation that was averaging a retained sponge every 16 days prior to 2003 27 . Thus, through focused, concerted and coordinated efforts, the Mayo Clinic, Rochester, as an institution, implemented multiple preventive strategies and audited its results serially to show a dramatic improvement and reduction of RSI rates.…”