Biomedical Sciences, Radboud University, Nijmegen, The Netherlands.
Institute of Quality Assurance and Patient Safety, Radboud University Medical Center, Nijmegen, The Netherlands.
Int J Clin Pract. 2021 Mar;75(3):e13689. doi: 10.1111/ijcp.13689. Epub 2020 Sep 21.
To evaluate the long-term (5 years) effects of perioperative briefing and debriefing on team climate. We explored the barriers and facilitators of the performance of perioperative briefing and debriefing to explain its effects on team climate and to make recommendations for further improvement of surgical safety tools.
A mixed-method evaluation study was carried out amongst surgical staff at a tertiary care university hospital with 593-bed capacity in the Netherlands. Thirteen surgical teams were included. Team climate inventory and a standardised evaluation questionnaire were used to measure team climate (primary outcome) and experiences with perioperative briefing and debriefing (secondary outcome), respectively. Thirteen surgical team members participated in a semi-structured interview to explore barriers and facilitators of the performance of perioperative briefing and debriefing.
The dimension "participative safety" increased significantly 5 years after the implementation of perioperative briefing and debriefing (P = .02 (95% confidence interval 1.18-9.25)). Perioperative briefing and debriefing were considered a useful method for improving and sustaining participative safety and cooperation within surgical teams. The positive aspects of briefing were that shared agreements made at the start of the day and that briefing enabled participants to work as a team. Participants were less satisfied regarding debriefing, mostly because of the lack of a sense of urgency and a lack of a safe culture for feedback. Briefing and debriefing had less influence on efficiency.
Although perioperative briefing and debriefing improve participative safety, the intervention will become more effective for maintaining team climate when teams are complete, irrelevant questions are substituted by customised ones and when there is a safer culture for feedback.
评估围手术期简报和汇报对团队氛围的长期（5 年）影响。我们探讨了围手术期简报和汇报实施的障碍和促进因素，以解释其对团队氛围的影响，并为进一步改进手术安全工具提出建议。
在荷兰一家拥有 593 张床位的三级护理大学医院的外科医护人员中进行了一项混合方法评估研究。共纳入 13 个外科团队。使用团队氛围量表和标准化评估问卷分别测量团队氛围（主要结局）和围手术期简报和汇报的经验（次要结局）。13 名外科团队成员参加了半结构化访谈，以探讨围手术期简报和汇报实施的障碍和促进因素。
围手术期简报和汇报实施 5 年后，“参与式安全”维度显著增加（P=0.02（95%置信区间 1.18-9.25））。围手术期简报和汇报被认为是改善和维持外科团队参与式安全和合作的有用方法。简报的积极方面是在一天开始时达成的共识，以及使参与者能够作为一个团队工作。参与者对汇报的满意度较低，主要是因为缺乏紧迫感和缺乏反馈的安全文化。简报和汇报对效率的影响较小。
尽管围手术期简报和汇报提高了参与式安全，但当团队成员完整、无关问题被定制问题取代以及反馈的安全文化建立时，该干预措施将更有效地维持团队氛围。
