title: Measuring briefing and checklist compliance in surgery: a tool for quality improvement.
abstract: Operating room briefings improve patient outcomes; however, implementation and methods to measure are lacking. A briefing audit tool was developed with 4 domains: briefing logistics, briefing basics, specific briefing content, and briefing participation. The tool evaluated preoperative briefings across surgical services at an academic medical center. Sixty-three preoperative briefings were observed. Introduction by name and role occurred in 15% of cases. There was a wide variation in discussion of the critical goals of the surgical procedure among services D (100%), A (26%), B (19%), and C (0%). Participation in the briefing was variable among stakeholders and between services. Verbal contributions were variable across all roles ranging from 65% (surgeons) to 11% (trainees and surgical technologist). Preoperative briefing compliance is variable. Deficiencies varied between service lines, possibly highlighting the need for service-specific customization of the briefing tool in surgery. This tool is a practical method for the study of briefing implementation.
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Fabian M
authors.initials: FM
authors.lastname: Johnston
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Tergas
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bennett
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Vicente
authors.initials: V
authors.lastname: Valero
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Candice K
authors.initials: CK
authors.lastname: Morrissey
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Fader
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Hobson
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Sallie J
authors.initials: SJ
authors.lastname: Weaver
authors.affiliation: The Johns Hopkins University, Baltimore, MD.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rosen
authors.affiliation: The Johns Hopkins University, Baltimore, MD ewick1@jhmi.edu.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Wick
mesh_terms: D057189:Checklist / Q000706:statistics & numerical data*; D003142:Communication; D006801:Humans; D009873:Operating Rooms / Q000379:methods* / Q000592:standards; D016134:Organizational Policy; D010348:Patient Care Team; D058996:Quality Improvement; D013514:Surgical Procedures, Operative / Q000379:methods* / Q000592:standards
keywords: OR safety; audit; communication; preoperative briefing; teamwork