Who's responsible for surgical counts at your facility? The surgeon? The nurse conducting the count? Others in the room? This accountability question is the one we recently set out to answer. Many nurses may still have the impression that the surgeon is solely responsible for the outcome of the counts. But the legal climate surrounding retained foreign objects has changed over the last few years. The surgeon as "captain of the ship" doctrine is gone. The nurse conducting the count, as well as others in the room, are now just as accountable as the surgeon. We spent 5 months updating our surgical count policy. As you'll see in this recap of the keys to our success, the final product uses our EMR to promote patient safety and addresses surgical sponges placed as packing, as well as other challenges your surgical teams face every day.