title: Impact of preoperative briefings on operating room delays: a preliminary report.
abstract: OBJECTIVE
  Preoperative briefings have the potential to reduce operating room (OR) delays through improved teamwork and communication.
  
  
  METHODS
  Pre-post study.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  Surgeons, anesthesiologists, nurses, and other OR personnel.
  
  
  METHODS
  An 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.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  The 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).
  
  
  CONCLUSIONS
  Preoperative 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.
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, 1909 Thames St, 2nd floor, Baltimore, MD 21231, USA.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Nundy
authors.forename: Arnab
authors.initials: A
authors.lastname: Mukherjee
authors.forename: J Bryan
authors.initials: JB
authors.lastname: Sexton
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.forename: Andrew
authors.initials: A
authors.lastname: Knight
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Rowen
authors.forename: Mark
authors.initials: M
authors.lastname: Duncan
authors.forename: Dora
authors.initials: D
authors.lastname: Syin
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
mesh_terms: D001291:Attitude of Health Personnel; D017598:Efficiency, Organizational; D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D009873:Operating Rooms / Q000458:organization & administration*; D010348:Patient Care Team; D015397:Program Evaluation; D013997:Time Factors; D017748:Time Management