The Universal Protocol protocol was created in response to a pervasive problem of wrong site, wrong patient surgeries that continue to be an issue today. The Joint Commission has identified several key factors that may explain the high number of these surgical mistakes. Contributing factors often include poor communication, noncompliance with procedures, and a lack of leadership. The time-out is a crucial step to preventing wrong-site surgeries, and a necessary step to comply with the Universal Protocol. The Joint Commission’s Universal Protocol consists of three key steps: Conduct a pre-procedure verification process, Mark the procedure site, Perform a time-out. While the time-out was introduced as a checkpoint to confirm the correct patient, procedure and site, it has become a cornerstone of a medical facility’s safety culture, and can significantly enhance surgical outcomes.