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Special Communication |

Improving Safety and Quality of Care With Enhanced Teamwork Through Operating Room Briefings

Caitlin W. Hicks, MD, MS1; Michael Rosen, PhD2; Deborah B. Hobson, RN1,2; Clifford Ko, MD, MS3; Elizabeth C. Wick, MD1
[+] Author Affiliations
1Department of Surgery, The Johns Hopkins University, Baltimore, Maryland
2Armstrong Institute, The Johns Hopkins University, Baltimore, Maryland
3Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois
JAMA Surg. 2014;149(8):863-868. doi:10.1001/jamasurg.2014.172.
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Objectives  To describe the current state of the science for operating room (OR) briefings and debriefings, including an overview of key definitions, a review of the evidence of effectiveness, and a summary of our experiences as part of a comprehensive unit–based safety program.

Overview  Use of preoperative briefings has been shown to improve team communication, decrease disruptions to surgical workflow, improve compliance with antibiotic and deep vein thrombosis prophylaxis, and improve overall perceptions about the safety climate in the OR. Studies have demonstrated that an effective briefing can be performed in less than 2 minutes and reduce delays by more than 80%. Effective implementation involves changing workflows and expectations of interaction among OR team members, including participation from leaders at all levels. Briefings and debriefings are a strategy for revealing defects and facilitating adaptive change in the OR.

Conclusions and Relevance  Briefings and debriefings are a good method for improving teamwork and communication in the OR. Effective implementation may be associated with improved patient outcomes. Commitment by the participating providers is essential for effective briefings, which include discussion of relevant information pertaining to the procedure.

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Figure 1.
Original Briefing and Debriefing Form

Original hospitalwide briefing and debriefing form. DVT indicates deep vein thrombosis; H & P, history and physical; ICU, intensive care unit; ID, identification; OR, operating room; PACU, post-anesthesia care unit; PCA, patient-controlled anesthesia; post op, postoperative; SSI, surgical site infections. Reproduced with permission from the authors.

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Figure 2.
Comprehensive Unit–Based Safety Program Debriefing Form

Briefing and debriefing form developed by the comprehensive unit–based safety program team. Abx indicates antibiotics; BG, blood glucose; CUSP, comprehensive unit–based safety program; d/c’d, discontinued; DOB, date of birth; DVT, deep vein thrombosis; Hgb, hemoglobin; Hob, head of bed; Hydro, hydrocortisone; ID, identification; N/A, not applicable; OR, operating room; pre-op, preoperative; Q8, every 8; SCDs, sequential compression devices; SubQ, subcutaneous. Reproduced with permission from the authors.

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