Department of Medicine Publications

Title

Evaluation of a Preoperative Checklist and Team Briefing among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication

Document Type

Article

Publication Date

1-2008

Journal

Archives of Surgery

Volume

143

Issue

1

First Page

12

Last Page

17

Abstract

OBJECTIVE: To assess whether structured team briefings improve operating room communication. Design, Setting, and

PARTICIPANTS: This 13-month prospective study used a preintervention/postintervention design. All staff and trainees in the division of general surgery at a Canadian academic tertiary care hospital were invited to participate. Participants included 11 general surgeons, 24 surgical trainees, 41 operating room nurses, 28 anesthesiologists, and 24 anesthesia trainees.

INTERVENTION: Surgeons, nurses, and anesthesiologists gathered before 302 patient procedures for a short team briefing structured by a checklist. Main Outcome Measure The primary outcome measure was the number of communication failures (late, inaccurate, unresolved, or exclusive communication) per procedure. Communication failures and their consequences were documented by 1 of 4 trained observers using a validated observational scale. Secondary outcomes were the number of checklist briefings that demonstrated "utility" (an effect on the knowledge or actions of the team) and participants' perceptions of the briefing experience.

RESULTS: One hundred seventy-two procedures were observed (86 preintervention, 86 postintervention). The mean (SD) number of communication failures per procedure declined from 3.95 (3.20) before the intervention to 1.31 (1.53) after the intervention (P < .001). Thirty-four percent of briefings demonstrated utility, including identification of problems, resolution of critical knowledge gaps, decision-making, and follow-up actions.

CONCLUSIONS: Interprofessional checklist briefings reduced the number of communication failures and promoted proactive and collaborative team communication.

Notes

Dr. Lorelei Lingard is currently a faculty member at The University of Western Ontario.

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