Briefing in the Operating Room — A Tool for Enhancing Coordination and Enriching Shared Knowledge Bases

Abstract

Surgical procedures are complex tasks performed by teams. Their success depends on individual competency and good team coordination. Performance on both individual and team level can greatly benefit from having a shared information basis of patient details, medical status, and planned surgical procedure. Team briefing prior to surgery may pave the way for developing a common reference and a more complete patient and surgery knowledge base. In addition to the obvious role of filling in missing information, broader and more complete knowledge bases can generate proper expectations, facilitate preplanning and improve members' decision making. We report preliminary results from an effort to develop an expanded briefing protocol, and its application in 78 gynecological operations. We compared the frequency of critical events in operations which utilized briefings, with 78 non-briefed operations. We revealed a significant decrease in the number of operations in which at least one team member manifested a lack of knowledge about the patient or the surgical procedure (e.g., allergies, side of operation, type of procedure). There was also a reduction of the number of events in which required equipment was missing or improperly assembled. These types of events increase the risk to the patient. Their reduction attests to the value of conducting briefings to improve team coordination and increase patient safety.

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