[Anesthetist's briefing check. Tool to improve patient safety in the operating room].
Adverse events are not unusual in a more and more complex anesthesiological environment. The main reasons for this are an increasing workload, economic pressure, growing expectations of patients and deficits in planning and communication. However, these incidents mostly do not refer to medical deficits but to flaws in non-technical skills (team organisation, task orientation, decision making and communication). The introduction of the WHO Safe Surgery Checklist depicted that a structural approach can improve the situation. However, it is still questionable if this measure is strong enough and recent publications revealed initial criticisms. Furthermore, remaining security gaps could be found even though the checklist was implemented in the anesthesiological practice of a big teaching hospital. Therefore, an additional checklist was developed to implement an anesthesia briefing in the daily routine. The main objective was to establish a security check before induction similar to the aeronautical pre-flight check. Additionally, this measure should improve coordination of the anesthesiology team. Working through the checklist, doctors and nurses are guided to focus on conjoint patient care prior to induction of anesthesia. In a web-based survey the general attitude of coworkers towards patient safety, as well as the acceptability of the new briefing check was scrutinised at two times: directly before implementation of the checklist and 1 year after. The results (84 % of medical and 97 % of healthcare staff answered the questionnaires) showed improvements with high relevance to parameters associated with awareness concerning safety issues and team coordination. In conclusion, it appears that patient safety can be significantly improved with little time effort of 3-5 min per patient. A prospective trial will be conducted to confirm the impact of this measure on improvements in patient safety.
Abteilung für Anästhesie, Notfall- und Allgemeine Intensivmedizin, Karl Landsteiner Institut für Medizinische Simulation und Patientensicherheit, Landesklinikum Wiener Neustadt, Corvinusring 3-5, 2700 Wiener Neustadt, Österreich. helmut.trimmel@wienerneustadt.lknoe.at
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Trimmel
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Fitzka
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Kreutziger
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von Goedecke
D000758:Anesthesia / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects; D057189:Checklist; D003142:Communication; D006801:Humans; D009873:Operating Rooms; D015279:Organizational Culture; D061214:Patient Safety
D000777:Anesthetics