It's understandable many people have a fear of surgery because there are so many risks.But there is one danger you may not have thought of -- nurses and other members of the surgical team being afraid to speak up if they spot a problem.There is growing evidence that poor communication between surgical teams and doctors is the leading cause of avoidable surgical errors.Mistakes like the wrong patient or procedure, or the right procedure on the wrong part of the body have happened in the operating room."There are just too many things that are happening in an operating room all at once for one person to be in charge," said Scripps Memorial Chief of Staff Dr. Dana Launer.Studies show that a big part of the problem is the intense atmosphere of the operating room."There are moments where it is nice and calm -- I call it organized chaos," said surgical nurse Christine Pedroni.It's a place where surgeons are captains of the ship. As a result, nurses and members of the surgical team can be afraid to speak up, but that's changing in operating rooms across the nation and in San Diego.Many hospitals have implemented a pre-flight check plan -- a brief time out before surgery to encourage anyone in the operating room who has a concern to speak out, 10News reported.Surgical teams at Scripps Memorial Hospital in La Jolla use a time out system to empower everyone on the surgical team to delay or even suspend a surgery if the team isn't in agreement."I think we are doing with our time out procedure what the airlines do before they take off on a flight," said Launer. "In the 21st century surgeons, in spite of their notorious big egos, understand they are part of the team and the collaborate effort that is important to take care of a patient." he said.Pedroni says the working environment has changed since she began her career 32 years ago."There were moments back then that it was difficult to speak up," said Pedroni.Now surgeons value all input from their team."We take our jobs very seriously, but there are checks and balances that take place every day along the way before, during and after every procedure to ensure that the patient is protected," said Launer.It's a safety pause that is helping hospital workers catch near misses.Scripps Memorial says the time out method has helped prevent surgical errors.Healthcare giant Kaiser Permanente is implementing the same type of safety pause in all 30 of its hospitals across the country.