Operating Room Briefings and Debriefings Improve Patient Safety

Beaumont piloted surgical briefing program with MHA in 2006

Briefings and debriefings in the operating rooms at Beaumont Hospital, Royal Oak have proven to enhance patient safety. When the surgical team takes time to communicate before the surgery and when it is complete, issues are identified which could prevent patient harm, according to an article published in the April issue of The Joint Commission Journal on Quality and Patient Safety [1].

Surgical briefings and debriefing enhance patient safety.

Beaumont’s surgical team began piloting the briefings and debriefings as part of the Michigan Health & Hospital Association Keystone: Surgery [2]project in late 2006 using a one-page, double-sided briefing and debriefing checklist. The goal was to improve communication in the OR and to find any potential safety issues and prevent them from happening. The first groups to try the tool were thoracic (chest) and orthopedic surgery teams. The project later expanded to include all elective and emergency surgeries. The briefings and debriefings became part of the ongoing surgical process to improve patient safety.

Through the briefings, issues in the operating room were identified and categorized by the surgical team. The categories included anesthesia, antibiotics, boarding, surgical instruments, OR equipment, supplies, lab, blood bank, bone bank, pharmacy, radiology, pre-op/post-anesthesia care, patient consent, communication, staffing, transportation, surgeon and process issues.

The issues identified each week were sent to operating room leadership, who would investigate the problems, provide feedback to surgical team members and implement solutions.

“The briefings identified more than 6,000 issues and, on average, 141 issues were discovered each month,” says Robert Welsh, M.D., co-author of the study and Beaumont thoracic surgeon. “We surveyed some of the surgical team members for their opinions. The vast majority of participants agreed that the briefings were useful and helpful to improving quality and patient safety in the OR.”

As a result of the briefings and debriefings, many patient safety issues were identified and new safety measures were implemented. These included re-educating support staff on cleaning and set-up for surgical cases, and developing protocols to ensure that blood typing, screening and cross matching are completed before the surgery to prevent delays.