If all members of the surgical team are present when the patient enters the room, can the sign-in time-out process be performed?

• A. Yes
• B. No
• C. Only after the surgeon's confirmation
• D. Only if anesthesia is present

Answer: (A)

The essential idea is that safety checks at the start of a case require the whole surgical team to participate. Sign-in is the initial verification step in the Universal Protocol, done when the patient is in the room and before anesthesia is given. When every key team member is present—surgeon, anesthesia provider, circulating nurse, and other essential staff—the group can collectively confirm the patient’s identity, the planned procedure, the correct site, any implants, allergies, and other critical details. This collaborative verification helps prevent wrong-site or wrong-procedure errors and sets a safety foundation before proceeding.

If all the necessary members are there, there’s nothing preventing performing the sign-in right then. If a required participant were missing, the team would pause to ensure that element is addressed so the sign-in and subsequent time-out can be completed accurately.