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LeadershipJanuary 20262 min read

Sign-in, time-out, sign-out

Adapted from my LinkedIn posts, January 2026 to April 2026.

I always feel good about sign-in, time-out and sign-out. These are three vital points during any surgical procedure.

Three checks during every operation

Sign-in happens before anaesthesia begins. Time-out happens just before the first incision. Sign-out happens before the patient leaves the operating room. At each point, the team stops together and confirms the essentials.

As a team, we learnt a lot from this boring-looking protocol. Patient safety is always our priority, and these pauses are where it is checked in practice.

Incident reporting is a tool for learning

Incident reporting is a potent tool. It should not be used as a way to complain or as a vehicle for prejudice.

The incident system strengthens any organisation. Without this feedback, investigation and root cause analysis (working back from an event to the underlying reason it happened), everyone will think that what they are doing is excellent.

To progress to a higher level, every person and every organisation needs to introspect. Incident reporting is one way to do this.

What we borrowed from the airlines

We learnt a lot from the airline industry. Their incidents are investigated, and the improvements are reflected in the healthcare industry.

That makes sense, because both are high-risk environments, where a small error or a teamwork issue may lead to a bigger disaster.

This article is general information, not medical advice. For advice about your own health, please see a doctor.