title: Operating room briefings and wrong-site surgery.
abstract: BACKGROUND
  Wrong-site surgery can be a catastrophic event for a patient, caregiver, and institution. Although communication breakdowns have been identified as the leading cause of wrong-site surgery, the efficacy of preventive strategies remains unknown. This study evaluated the impact of operating room briefings on coordination of care and risk for wrong-site surgery.
  
  
  METHODS
  We administered a case-based version of the Safety Attitudes Questionnaire (SAQ) to operating room (OR) staff at an academic medical center, before and after initiation of an OR briefing program. Items questioned overall coordination and awareness of the surgical site. Response options ranged from 1 (disagree strongly) to 5 (agree strongly). MANOVA was used to compare caregiver assessments before and after the implementation of briefings, and the percentage of OR staff agreeing or disagreeing with each question was reported.
  
  
  RESULTS
  The prebriefing response rate was 85% (306 of 360 respondents), and the postbriefing response rate was 75% (116 of 154). Respondents included surgeons (34.9%), anesthesiologists (14.0%), and nurses (44.4%). Briefings were associated with caregiver perceptions of reduced risk for wrong-site surgery and improved collaboration [F (6,390)=10.15, p < 0.001]. Operating room caregiver assessments of briefing and wrong-site surgery issues improved for 5 of 6 items, eg, "Surgery and anesthesia worked together as a well-coordinated team" (67.9% agreed prebriefing, 91.5% agreed postbriefing, p < 0.0001), and "A preoperative discussion increased my awareness of the surgical site and side being operated on" (52.4% agreed prebriefing, 64.4% agreed postbriefing, p < 0.001).
  
  
  CONCLUSIONS
  OR briefings significantly reduce perceived risk for wrong-site surgery and improve perceived collaboration among OR personnel.
authors.affiliation: Department of Surgery, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD 21224, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: Arnab
authors.initials: A
authors.lastname: Mukherjee
authors.forename: J Bryan
authors.initials: JB
authors.lastname: Sexton
authors.forename: Dora
authors.initials: D
authors.lastname: Syin
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Goodrich
authors.forename: Emily
authors.initials: E
authors.lastname: Hartmann
authors.forename: Lisa
authors.initials: L
authors.lastname: Rowen
authors.forename: Drew C
authors.initials: DC
authors.lastname: Behrens
authors.forename: Michael
authors.initials: M
authors.lastname: Marohn
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
mesh_terms: D000776:Anesthesiology; D001291:Attitude of Health Personnel; D003142:Communication; D013502:General Surgery; D006801:Humans; D007400:Interprofessional Relations; D019300:Medical Errors / Q000517:prevention & control*; D009493:Neurosurgery; D009871:Operating Room Nursing; D009873:Operating Rooms / Q000458:organization & administration*; D012307:Risk Factors; D012449:Safety; D013518:Surgery, Plastic; D000078329:Workforce