Implementing Standardized Operating Room Briefings and Debriefings at a Large Regional Medical Center

被引：38

作者：

Berenholtz, Sean M. ^{[1
,2
]}

Schumacher, Kathy ^{[3
]}

Hayanga, Awori J. ^{[4
]}

Simon, Michelle ^{[3
]}

Goeschel, Christine ^{[5
,6
]}

Pronovost, Peter J. ^{[7
,8
,9
]}

Shanley, Charles J. ^{[10
,11
]}

Welsh, Robert J. ^{[12
,13
]}

机构：

[1] Johns Hopkins Univ, Johns Hopkins Qual & Safety Res Grp, Baltimore, MD USA

[2] Johns Hopkins Univ, Anesthesiol Crit Care Med & Surg, Baltimore, MD USA

[3] William Beaumont Hosp, Dept Qual Safety Stand & Outcomes, Royal Oak, MI 48072 USA

[4] Univ Michigan, Dept Gen Surg, Ann Arbor, MI 48109 USA

[5] Johns Hopkins Univ, Patient Safety & Qual Initiat, Baltimore, MD 21218 USA

[6] Johns Hopkins Univ, Operat, Baltimore, MD 21218 USA

[7] Johns Hopkins Univ, Adult Crit Care, Sch Med, Baltimore, MD 21218 USA

[8] Johns Hopkins Univ, Adult Crit Care, Sch Nursing, Baltimore, MD 21218 USA

[9] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA

[10] William Beaumont Hosp, Surg Serv, Royal Oak, MI 48072 USA

[11] William Beaumont Hosp, Dept Surg, Royal Oak, MI 48072 USA

[12] William Beaumont Hosp, Surg Serv Surg Qual Safety & Outcomes, Royal Oak, MI 48072 USA

[13] William Beaumont Hosp, Thorac Surg, Dept Surg, Royal Oak, MI 48072 USA

来源：

JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY | 2009年 / 35卷 / 08期

基金：

美国国家卫生研究院; 美国医疗保健研究与质量局;

关键词：

D O I：

10.1016/S1553-7250(09)35055-2

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Effective communication and teamwork are critical in many health care settings, particularly the operating room (OR). Several studies have implicated failures of communication and teamwork as the root cause in a high proportion of sentinel events in the OR. Methods: In a prospective cohort study at a high-volume teaching, research, and tertiary care referral hospital, a standardized one-page briefing and debriefing tool was developed and implemented in October 2006 to improve interdisciplinary communication and teamwork in the OR. The briefing portion of the tool was completed by the surgical team after the patient's final positioning and before incision; the debriefing portion was initiated and completed by the circulating nurse after the first counts were conducted. Compliance was calculated as the number of cases where the briefing and debriefing tool was completed divided by the total number of eligible cases. Surveys (n = 40) were conducted to elicit caregiver perceptions of interdisciplinary communication and teamwork in the OR and the burden and average time taken to complete the briefing and debriefing tool. Results: Between October 2006 and March 2008, 37,133 briefings and debriefings were conducted. Average compliance varied over time since implementation, with overall compliance ranging from 76% to 95%. The majority of caregivers perceived that the briefing and debriefing tool improved interdisciplinary communication and teamwork. On average, it took 2.9 minutes (range, 1-5 minutes) to complete the briefing portion of the tool and 2.5 minutes (range, 1-5 minutes) to complete the debriefing portion. Discussion: Implementation of a standardized briefing and debriefing tool in a large regional medical center was a practical and feasible strategy to improve perceptions of interdisciplinary communication and teamwork in the OR.

引用

页码：391 / +

页数：10

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