title: Implementing standardized operating room briefings and debriefings at a large regional medical center.
abstract: BACKGROUND
  Effective communication and teamwork are critical in many health care settings, particularly the operating room (OR). Several studies have implicated failures of communication and teamwork as the root cause in a high proportion of sentinel events in the OR.
  
  
  METHODS
  In a prospective cohort study at a high-volume teaching, research, and tertiary care referral hospital, a standardized one-page briefing and debriefing tool was developed and implemented in October 2006 to improve interdisciplinary communication and teamwork in the OR. The briefing portion of the tool was completed by the surgical team after the patient's final positioning and before incision; the debriefing portion was initiated and completed by the circulating nurse after the first counts were conducted. Compliance was calculated as the number of cases where the briefing and debriefing tool was completed divided by the total number of eligible cases. Surveys (n=40) were conducted to elicit caregiver perceptions of interdisciplinary communication and teamwork in the OR and the burden and average time taken to complete the briefing and debriefing tool.
  
  
  RESULTS
  Between October 2006 and March 2008, 37,133 briefings and debriefings were conducted. Average compliance varied over time since implementation, with overall compliance ranging from 76% to 95%. The majority of caregivers perceived that the briefing and debriefing tool improved interdisciplinary communication and teamwork. On average, it took 2.9 minutes (range, 1-5 minutes) to complete the briefing portion of the tool and 2.5 minutes (range, 1-5 minutes) to complete the debriefing portion.
  
  
  CONCLUSIONS
  Implementation of a standardized briefing and debriefing tool in a large regional medical center was a, practical and feasible strategy to improve perceptions of interdisciplinary communication and teamwork in the OR.
authors.affiliation: Johns Hopkins Quality and Safety Research Group, Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Berenholtz
authors.forename: Kathy
authors.initials: K
authors.lastname: Schumacher
authors.forename: Awori J
authors.initials: AJ
authors.lastname: Hayanga
authors.forename: Michelle
authors.initials: M
authors.lastname: Simon
authors.forename: Christine
authors.initials: C
authors.lastname: Goeschel
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Shanley
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Welsh
mesh_terms: D015331:Cohort Studies; D003299:Cooperative Behavior; D019983:Guideline Adherence; D019538:Health Care Surveys; D006769:Hospitals, General; D006801:Humans; D033183:Interdisciplinary Communication; D009873:Operating Rooms / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D014481:United States