The Joint Commission Board of Commissioners originally approved the universal protocol for wrong site prevent wrong procedure and wrong person SurgeryTM in July 2003, and it joined 1 July 2004 for all accredited hospitals, ambulatory care and Office-based surgery facilities. The universal protocol was created to the continuing occurrence of wrong site, wrong procedure and surgery in Joint Commission accredited organizations address wrong person. The universal Protocol to moved and expanded and integrated a number of requirements under the Joint Commission in 2003 and 2004 national patient safety goals. There are three main components of the universal Protocol: conducting a preprocedure verification process, marking the procedure site, and a timeout before the procedure to perform.

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