• Arch Surg · Jan 2008

    Evaluation of a preoperative checklist and team briefing among surgeons, nurses, and anesthesiologists to reduce failures in communication.

    • Lorelei Lingard, Glenn Regehr, Beverley Orser, Richard Reznick, G Ross Baker, Diane Doran, Sherry Espin, John Bohnen, and Sarah Whyte.
    • University of Toronto, 200 Elizabeth St, Eaton South 1-565, Toronto ON M5G 2C4, Canada. lorelei.lingard@utoronto.ca
    • Arch Surg. 2008 Jan 1;143(1):12-7; discussion 18.

    ObjectiveTo assess whether structured team briefings improve operating room communication.Design, Setting, And ParticipantsThis 13-month prospective study used a preintervention/postintervention design. All staff and trainees in the division of general surgery at a Canadian academic tertiary care hospital were invited to participate. Participants included 11 general surgeons, 24 surgical trainees, 41 operating room nurses, 28 anesthesiologists, and 24 anesthesia trainees.InterventionSurgeons, nurses, and anesthesiologists gathered before 302 patient procedures for a short team briefing structured by a checklist. Main Outcome Measure The primary outcome measure was the number of communication failures (late, inaccurate, unresolved, or exclusive communication) per procedure. Communication failures and their consequences were documented by 1 of 4 trained observers using a validated observational scale. Secondary outcomes were the number of checklist briefings that demonstrated "utility" (an effect on the knowledge or actions of the team) and participants' perceptions of the briefing experience.ResultsOne hundred seventy-two procedures were observed (86 preintervention, 86 postintervention). The mean (SD) number of communication failures per procedure declined from 3.95 (3.20) before the intervention to 1.31 (1.53) after the intervention (P < .001). Thirty-four percent of briefings demonstrated utility, including identification of problems, resolution of critical knowledge gaps, decision-making, and follow-up actions.ConclusionsInterprofessional checklist briefings reduced the number of communication failures and promoted proactive and collaborative team communication.

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