Elective Procedures Informed Consent Informed consent for an elective surgical procedure is best obtained by the physician in the office/clinic setting a few days before the scheduled procedure Surgeon must provide to the patient all information that is needed for the patient to make an informed decision who will be performing surgery should be disclosed the surgeon should disclose to the patient at the time of scheduling an "exposure prone" procedure if the surgeon has tested positive for HIV, Hepatitis B or C Important to understand the important risks and benefits as well as the indications for and alternatives to a procedure Origin of surgical implants should be discussed with patients this may have implications for their use based on a patient's religious background in Hinduism, use of bovine derived implants should be discussed in Judaism and Islam, use of porcine derived implants should be discussed Emergency Procedure Informed Consent confirm necessity of procedure in situation of required surgery for life threatening injury without available legal consent the surgeon should confirm and document the necessity of care with a fellow orthopaedic surgeon or colleague in non-life threatening injury, consent must be obtained prior to intervention (e.g. language barrier, pediatric patient) The "Next of Kin" precedence that has been established is in the following order: spouse, children (in no order), parents, siblings, grandchildren Informed Consent for Clinical Trial Health Information Portability and Accountability Act (HIPAA) Provider does not need consent from patient to communicate HIPAA protected information to other treating providers Process for obtaining informed consent for patients included in clinical trials is mandated by the Institutional Review Board (IRB) IRB approval is not required for quality improvement studies used for internal purposes only Surgical Safety Checklists WHO implementation of surgical safety checklists began in 2009 Implementation has demonstrated measureable improvements in: surgical mortality in-hospital complications adherence to surgical plan in OR crisis situations (e.g., massive hemorrhage, cardiac arrest)