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The Orthopaedic Forum   |    
Patient Safety in North America: Beyond “Operate Through Your Initials” and “Sign Your Site”*
David A. Wong, MD, MSc, FRCS(C)1; Brendan Lewis, MD, FRCS(C)2; James Herndon, MD, MBA3; Claude MartinJr., MD, FRCS(C), CSPQ, MBA4; Robert Brooks, MD, PhD, MBA5
1 Denver Spine, Suite 100, 7800 East Orchard Road, Greenwood Village, CO 80111. E-mail address: ddaw@denverspine.com
2 CIBC Building, 3rd Floor, Suite 301, Box 814, Station Main, Cornerbrook, NL A2H 6H6, Canada. E-mail address: blewis@thezone.net
3 Massachusetts General Hospital, 55 Fruit Street, White 542, Boston, MA 02114. E-mail address: jherndon@partners.org
4 The Canadian Medical Protective Association (CMPA), 875 Carling Avenue, P.O. Box 8225, Stn T, Ottawa, ON K1G 3H7, Canada. E-mail address: cmartin@cmpa.org
5 Delmarva Foundation for Medical Care, 6940 Columbia Gateway Drive, Columbia, MD 21046-2788. E-mail address: bobbrooksster@gmail.com
View Disclosures and Other Information
This symposium was presented at the Combined Meeting of the American Orthopaedic Association and the Canadian Orthopaedic Association in Quebec City, Quebec, Canada, on June 6, 2008.
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Jun 01;91(6):1534-1541. doi: 10.2106/JBJS.H.01462
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Extract

Orthopaedic surgeons in Canada and the United States have been leaders in the patient safety movement1-8. Early efforts addressed wrong-site surgery. Both the "Operate Through Your Initials" program9, introduced in 1993 by the Canadian Orthopaedic Association (COA), and the "Sign Your Site" initiative10,11, introduced in 1998 by the American Academy of Orthopaedic Surgeons (AAOS), predate the 2000 publication of To Err is Human: Building a Safer Health System by the Institute of Medicine12. That report estimated that between 44,000 and 98,000 patient deaths from medical errors occurred in the United States each year. Following that report and the associated media attention, there has been more widespread interest in patient safety and medical errors.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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