Impact of Preoperative Briefings on Operating Room Delays A Preliminary Report

被引:101
作者
Nundy, Shantanu [2 ]
Mukherjee, Arnab [2 ,6 ,7 ]
Sexton, J. Bryan [2 ]
Pronovost, Peter J. [2 ,4 ,5 ]
Knight, Andrew
Rowen, Lisa C. [5 ]
Duncan, Mark [3 ]
Syin, Dora [2 ]
Makary, Martin A. [1 ,2 ,4 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Surg, Ctr Surg Outcomes Res, Baltimore, MD 21231 USA
[2] Johns Hopkins Univ, Qual & Safety Res Grp, Dept Anesthesiol, Baltimore, MD 21231 USA
[3] Johns Hopkins Univ, Dept Surg, Johns Hopkins Bayview Med Ctr, Baltimore, MD 21231 USA
[4] Johns Hopkins Univ, Sch Med, Dept Hlth Policy & Management, Baltimore, MD 21231 USA
[5] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Sch Nursing, Baltimore, MD 21231 USA
[6] Yale Univ, Sch Med, New Haven, CT USA
[7] Yale Univ, Sch Management, New Haven, CT USA
关键词
D O I
10.1001/archsurg.143.11.1068
中图分类号
R61 [外科手术学];
学科分类号
摘要
Hypothesis: Preoperative briefings have the potential to reduce operating room ( OR) delays through improved teamwork and communication. Design: Pre-post study. Setting: Tertiary academic center. Participants: Surgeons, anesthesiologists, nurses, and other OR personnel. Intervention: An OR briefings program was implemented after training all OR staff in how to conduct pre-operative briefings through in-service training sessions. During the preoperative briefings, the attending surgeon led OR personnel in a 2-minute discussion using a standardized format designed to familiarize caregivers with each other and the operative plan before each surgical procedure. Main Outcome Measures: The OR Briefings Assessment Tool was distributed to OR personnel at the end of each operation. Survey items questioned OR personnel about unexpected delays during each procedure and the relationship between communication breakdowns and delays. Responses were compared before and after the initiation of the preoperative briefings program. Results: The use of preoperative briefings was associated with a 31% reduction in unexpected delays; 36% of OR personnel reported delays in the preintervention period, and 25% reported delays in the postintervention period (P < .04). Among surgeons alone, an 82% reduction in unexpected delays was observed (P < .001). A 19% reduction in communication breakdowns leading to delays was also associated with the use of briefings (P < .006). Conclusions: Preoperative briefings reduced unexpected delays in the OR by 31% and decreased the frequency of communication breakdowns that lead to delays. Preoperative briefings have the potential to increase OR efficiency and thereby improve quality of care and reduce cost.
引用
收藏
页码:1068 / 1072
页数:5
相关论文
共 17 条
[1]
[Anonymous], 2001, CROSS QUAL CHASM NEW
[2]
Comparison of open versus bedside percutaneous dilatational tracheostomy in the cardiothoracic surgical patient: Outcomes and financial analysis [J].
Bacchetta, MD ;
Girardi, LN ;
Southard, EJ ;
Mack, CA ;
Ko, W ;
Tortolani, AJ ;
Krieger, KH ;
Isom, OW ;
Lee, LY .
ANNALS OF THORACIC SURGERY, 2005, 79 (06) :1879-1885
[3]
Dwyer Kathleen, 2003, J Med Pract Manage, V18, P332
[4]
Overlapping induction of anesthesia - An analysis of benefits and costs [J].
Hanss, R ;
Buttgereit, B ;
Tonner, PH ;
Bein, B ;
Schleppers, A ;
Steinfath, M ;
Scholz, J ;
Bauer, M .
ANESTHESIOLOGY, 2005, 103 (02) :391-400
[5]
Forming professional identities on the health care team: discursive constructions of the 'other' in the operating room [J].
Lingard, L ;
Reznick, R ;
DeVito, I ;
Espin, S .
MEDICAL EDUCATION, 2002, 36 (08) :728-734
[6]
Operating room teamwork among physicians and nurses: Teamwork in the eye of the beholder [J].
Makary, MA ;
Sexton, JB ;
Freischlag, JA ;
Holzmueller, CG ;
Millman, A ;
Rowen, L ;
Pronovost, PJ .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2006, 202 (05) :746-752
[7]
Patient safety in surgery [J].
Makary, MA ;
Sexton, JB ;
Freischlag, JA ;
Millman, EA ;
Pryor, D ;
Holzmueller, C ;
Pronovost, PJ .
ANNALS OF SURGERY, 2006, 243 (05) :628-635
[8]
Operating room briefings and wrong-site surgery [J].
Makary, Martin A. ;
Mukherjee, Arnab ;
Sexton, J. Bryan ;
Syin, Dora ;
Goodrich, Emmanuelle ;
Hartmann, Emily ;
Rowen, Lisa ;
Behrens, Drew C. ;
Marohn, Michael ;
Pronovost, Peter J. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2007, 204 (02) :236-243
[9]
Operating Room Briefings: Working on the Same Page [J].
Makary, Martin A. ;
Holzmueller, Christine G. ;
Thompson, David ;
Rowen, Lisa ;
Heitmiller, Eugenie S. ;
Maley, Warren R. ;
Black, James H. ;
Stegner, Katherine ;
Freischlag, Julie A. ;
Ulatowski, John A. ;
Pronovost, Peter J. .
JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY, 2006, 32 (06) :351-355
[10]
Achieving the National Quality Forum's "Never Events" - Prevention of wrong site, wrong procedure, and wrong patient operations [J].
Michaels, Robert K. ;
Makary, Martin A. ;
Dahab, Yasser ;
Frassica, Frank J. ;
Heitmiller, Eugenie ;
Rowen, Lisa C. ;
Crotreau, Richard ;
Brem, Henry ;
Pronovost, Peter J. .
ANNALS OF SURGERY, 2007, 245 (04) :526-532