Nundy et al examined the impact of a pre operative briefing on operating room delays and found that a pre operative briefing reduced unexpected delays by 31%. The authors developed a pre operative briefing tool that included the names and roles of the team members, the time out process, confirmation of antibiotics, a review of the critical steps in the procedure, and a review of the potential problems for the case. The review was done by the nurse, anesthesiologist and surgeon and took place just prior to the skin incision. Data was collected for two months prior to the introduction of the briefing protocol and this was compared to data collected for three months after the process was introduced (pre intervention and post intervention). The briefing process took about 2 minutes. Data on delays were collected using an OR briefing assessment tool completed by participants at the end of each operation. To the question “there was an unexpected delay related to the case”, during the pre intervention period 36% of the respondents agreed, while post intervention 25% of the respondents agreed; a reduction of 30%. To the question “communication breakdowns that lead to delays in starting a surgical procedure are common” pre intervention 80% agreed, while post intervention this was reduced to 65%. When examining the responses of surgeons reporting unexpected delays, the percentage decreased from 38% to 7% in the pre compared to the post intervention period. The authors suggested that a pre operative OR briefing process may improve OR efficiency by decreasing delays. They cited other work suggesting that a standardized communication process such as an OR briefing may also improve patient safety and outcome. Ref: Nundy S. et al: Impact of preoperative briefings on operating rooms delays. A preliminary report. Arch Surg 2008;143:1068 -1072.
David S. Smith M.D., Ph.D.