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Preoperative briefings reduce operating room delays

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – A brief discussion among members of the operating room team just before surgery begins to outline the procedure and review important components can significantly reduce delays in this setting, new research shows.

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.” Reference:
Arch Surg 2008;143:1068-1072.