Surgical team briefings may improve patient safety

Teamwork promoted at the short presurgical meetings encouraged members to speak up if they detected something out of the ordinary during an operation, study says.

By Susan J. Landers — Posted June 19, 2009

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Preoperative briefings involving all members of a surgical team can decrease disruptions and miscommunications during a procedure and may improve patient safety, according to a study in the June Journal of the American College of Surgeons (link).

The study, conducted at the Mayo Clinic in Rochester, Minn., found that briefings resulted in fewer miscommunications -- 1.17 versus 2.5 per operation. During the meetings, each member of a surgical team reports his or her plan for the pending operation and asks questions or raises issues.

"Briefings get everyone together, and they get their minds wrapped around this particular case," said co-investigator Thoralf M. Sundt III, MD, a professor of surgery in Mayo's division of cardiovascular surgery. "I'm convinced they make it safer for patients."

The briefing protocol was pilot-tested during 16 of Dr. Sundt's operations. The cardiac-specific protocol was designed with the input of 56 surgical staff, including assistants, technicians and nurses. The time to complete a briefing was initially eight minutes but dropped to one minute as staff became familiar with the process, the study said.

The briefings go beyond surgical checklists, which review patient identity, surgical site, procedure and equipment, the study noted.

Although some items, such as giving an antibiotic before an operation, are perfect for a checklist, briefings are better at developing the teamwork that is helpful for detecting unanticipated errors, Dr. Sundt said.

Initially, Dr. Sundt said he had to be convinced the concept was a good idea. "I don't have time to do this and I don't need this," he told a protocol developer.

But Dr. Sundt changed his mind after he started doing it. "Now I feel uncomfortable not doing it."

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