Nundy Shantanu, Mukherjee Arnab, Sexton J Bryan, Pronovost Peter J, Knight Andrew, Rowen Lisa C, Duncan Mark, Syin Dora, Makary Martin A
Department of Surgery, The Johns Hopkins University School of Medicine, 1909 Thames St, 2nd floor, Baltimore, MD 21231, USA.
Arch Surg. 2008 Nov;143(11):1068-72. doi: 10.1001/archsurg.143.11.1068.
Preoperative briefings have the potential to reduce operating room (OR) delays through improved teamwork and communication.
Pre-post study.
Tertiary academic center.
Surgeons, anesthesiologists, nurses, and other OR personnel.
An OR briefings program was implemented after training all OR staff in how to conduct preoperative 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.
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.
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).
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.
术前简报有潜力通过改善团队合作与沟通来减少手术室(OR)延误。
前后对照研究。
三级学术中心。
外科医生、麻醉师、护士及其他手术室人员。
在通过在职培训课程对所有手术室工作人员进行如何进行术前简报的培训后,实施了一项手术室简报计划。在术前简报期间,主刀外科医生带领手术室人员使用标准化格式进行2分钟的讨论,旨在使医护人员在每次手术前相互熟悉并了解手术计划。
每次手术结束时,向手术室人员发放手术室简报评估工具。调查项目询问手术室人员关于每个手术过程中的意外延误以及沟通障碍与延误之间的关系。将术前简报计划启动前后的回答进行比较。
术前简报的使用与意外延误减少31%相关;36%的手术室人员报告在干预前期有延误,而在干预后期这一比例为25%(P<.04)。仅就外科医生而言,意外延误减少了82%(P<.001)。简报的使用还与导致延误的沟通障碍减少19%相关(P<.006)。
术前简报使手术室意外延误减少了31%,并降低了导致延误的沟通障碍的发生率。术前简报有潜力提高手术室效率,从而改善护理质量并降低成本。