1. Pre-Procedure Checklist Verification of patient, procedure, site at time of admission or entry Relevant documents match to the correct patient, procedure and site: H&P/progress note relevant to the intended procedure H&P is updated if performed prior to day of procedure Nursing assessment Pre-anesthesia/sedation assessment performed Completed informed consent form signed by LIP and patient Correctly labeled diagnostic and radiology test results Required blood products, implants, devices and/or special equipment SCIP Measures (VTE, Beta Blockers, etc.)

2. Pre-Induction Pause Has the patient confirmed his/her identity, site, procedure and consent? Is the site marked (if applicable)? Is the anesthesia machine and medication check complete? Is pulse oximeter on and functioning? Does the patient have a Known allergy? Difficult airway/aspiration risk (if yes, is difficult airway cart in room?) Risk of >500ml blood loss (if yes, are 2 IVs/central access and fluids planned?) Risk of hypothermia (if yes, fluid and forced air warmer is available) Risk of malignant hyperthermia (if yes, discussed with staff)

3. Pre-Incision Timeout Have all new team members been introduced by name and role? What is the patient’s name? What procedure is planned? Where will the incision be made? (Is site/level marked?) Does the procedure and site match the informed consent form? Is the patient positioned correctly? Are relevant images and results properly labeled and displayed? Has antibiotic been started and are needed irrigation fluids available? Has the skin prep evaporated fully? Are blood products, implants, devices, & special equipment available? Are there any anticipated critical events (e.g., airway, blood, duration)? Are there any safety concerns regarding patient Hx, allergies, medications?

4. IntraOP/Post-Procedure Debrief/Huddle How shall I record the name of the procedure Are the instrument, sponge and needle counts complete? How shall I label the specimens? What are the key concerns for recovery and management of this patient? Any “went wells”? Any “to improves”?