• Shantanu Nundy, Arnab Mukherjee, J Bryan Sexton, Peter J Pronovost, Andrew Knight, Lisa C Rowen, Mark Duncan, Dora Syin, and Martin A Makary.
• Department of Surgery, The Johns Hopkins University School of Medicine, 1909 Thames St, 2nd floor, Baltimore, MD 21231, USA.
• Arch Surg. 2008 Nov 1;143(11):1068-72.

HypothesisPreoperative briefings have the potential to reduce operating room (OR) delays through improved teamwork and communication.DesignPre-post study.SettingTertiary academic center.ParticipantsSurgeons, anesthesiologists, nurses, and other OR personnel.InterventionAn 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.Main Outcome MeasuresThe 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.ResultsThe 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).ConclusionsPreoperative 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.

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