The briefing intervention, developed by Dr. Martin A. Makary and colleagues, from Johns Hopkins University School of Medicine, Baltimore, involves a 2-minute discussion using a standard format and led by the attending surgeon. The operative plan is discussed and the team also reviews a checklist of important items for the surgery, such as thromboembolic prophylaxis, instrumentation and potential hazards.
In the study, reported in the Archives of Surgery for November, the researchers used a standardized questionnaire to assess operative delays before and after the briefing intervention was implemented at their center. The study included 11 surgeons and the pre- and post-intervention phases were each 2 months long.
The intervention cut unexpected operative delays by 31%, the report shows. With implementation of the intervention, the proportion of OR personnel reporting delays fell from 36% to 25% (p < 0.04).
When the analysis was limited to surgeons, reported delays fell by 82% (p < 0.001), the researchers point out.
Use of the briefings was also tied to a 19% reduction in communication breakdowns, the report shows.
In light of these results, the authors conclude that “hospitals should consider implementing OR briefings as a strategy to improve OR efficiency and clinical and economic outcomes in surgical patients.”
Arch Surg 2008;143:1068-1072.