Evaluation of a preoperative checklist and team briefing among surgeons, nurses, and anesthesiologists to reduce failures in communication.
OBJECTIVE
To assess whether structured team briefings improve operating room communication.


METHODS
This 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.


METHODS
Surgeons, 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.


RESULTS
One 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.


CONCLUSIONS
Interprofessional checklist briefings reduced the number of communication failures and promoted proactive and collaborative team communication.
Lingard
Lorelei
L
University of Toronto, 200 Elizabeth St, Eaton South 1-565, Toronto ON M5G 2C4, Canada. lorelei.lingard@utoronto.ca
Regehr
Glenn
G
Orser
Beverley
B
Reznick
Richard
R
Baker
G Ross
GR
Doran
Diane
D
Espin
Sherry
S
Bohnen
John
J
Whyte
Sarah
S
D000328:Adult; D000776:Anesthesiology / Q000458:organization & administration; D003142:Communication; D005069:Evaluation Studies as Topic; D005260:Female; D013502:General Surgery / Q000458:organization & administration*; D006302:Health Services Research; D006784:Hospitals, Teaching; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009746:Nursing, Team / Q000458:organization & administration; D016017:Odds Ratio; D009864:Ontario; D009873:Operating Rooms; D010348:Patient Care Team / Q000458:organization & administration*; D011336:Probability; D011446:Prospective Studies; D017751:Safety Management / Q000458:organization & administration*; D017749:Total Quality Management