Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Evaluation of a Preoperative Checklist and Team Briefing Among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication—Invited Critique

Evaluation of a Preoperative Checklist and Team Briefing Among Surgeons, Nurses, and... The contrasting performance between 2 US Olympic teams is a testament to the power of teamwork. The men's 2004 basketball “dream team” had autonomous stars who were individually considered to be the best in the world, yet they performed poorly as a team. The 1980 hockey team was less skilled but superior in teamwork; it won the gold medal against tremendous odds. The article by Lingard and colleagues points to a vision in which the surgical team functions more like the hockey team than the dream team. Standardizing work tasks and creating independent checks for key work processes are recognized strategies to improve technical work; these strategies can also be applied to improve teamwork. Lingard and colleagues demonstrated that operative briefings—a form of structured communication with independent checks—were associated with reduced communication failures; 34% of these briefings demonstrated clinical utility. Although improved teamwork may have an impact on clinical and operational outcomes, staff satisfaction, and turnover, the authors did not evaluate these outcomes. The authors should be commended for their approach to obtain broad consensus in developing and implementing briefings and for their rigor in evaluating communication. This study adds to the science of patient safety. Despite these successes, uncertainty remains regarding the relative value of checklists vs open-ended questions in briefings. The caregivers conducting the briefings will likely be the best ones to make this decision. Although detailed checklists may help ensure that patients receive specific evidence-based interventions, open-ended questions could help make operative hazards more visible. The relative costs and benefits of these 2 strategies have yet to be determined. Nevertheless, this well-done study adds further evidence regarding the benefit of structured communication and advocates for a surgical team that performs more like the 1980 hockey team than the 2004 dribbling dream team. Correspondence: Dr Pronovost, Departments of Anesthesiology and Critical Care Medicine and Health Policy, Johns Hopkins University School of Medicine, 1909 Thames St, 2nd Floor, Baltimore, MD 21231 (ppronovo@jhmi.edu). Financial Disclosure: Dr Pronovost has a grant from the Michigan Hospital Association to improve safety in surgery. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Evaluation of a Preoperative Checklist and Team Briefing Among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication—Invited Critique

Evaluation of a Preoperative Checklist and Team Briefing Among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication—Invited Critique

Abstract

The contrasting performance between 2 US Olympic teams is a testament to the power of teamwork. The men's 2004 basketball “dream team” had autonomous stars who were individually considered to be the best in the world, yet they performed poorly as a team. The 1980 hockey team was less skilled but superior in teamwork; it won the gold medal against tremendous odds. The article by Lingard and colleagues points to a vision in which the surgical team functions more like the hockey...
Loading next page...
 
/lp/american-medical-association/evaluation-of-a-preoperative-checklist-and-team-briefing-among-pn3llvSGwy
Publisher
American Medical Association
Copyright
Copyright © 2008 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.2007.22
Publisher site
See Article on Publisher Site

Abstract

The contrasting performance between 2 US Olympic teams is a testament to the power of teamwork. The men's 2004 basketball “dream team” had autonomous stars who were individually considered to be the best in the world, yet they performed poorly as a team. The 1980 hockey team was less skilled but superior in teamwork; it won the gold medal against tremendous odds. The article by Lingard and colleagues points to a vision in which the surgical team functions more like the hockey team than the dream team. Standardizing work tasks and creating independent checks for key work processes are recognized strategies to improve technical work; these strategies can also be applied to improve teamwork. Lingard and colleagues demonstrated that operative briefings—a form of structured communication with independent checks—were associated with reduced communication failures; 34% of these briefings demonstrated clinical utility. Although improved teamwork may have an impact on clinical and operational outcomes, staff satisfaction, and turnover, the authors did not evaluate these outcomes. The authors should be commended for their approach to obtain broad consensus in developing and implementing briefings and for their rigor in evaluating communication. This study adds to the science of patient safety. Despite these successes, uncertainty remains regarding the relative value of checklists vs open-ended questions in briefings. The caregivers conducting the briefings will likely be the best ones to make this decision. Although detailed checklists may help ensure that patients receive specific evidence-based interventions, open-ended questions could help make operative hazards more visible. The relative costs and benefits of these 2 strategies have yet to be determined. Nevertheless, this well-done study adds further evidence regarding the benefit of structured communication and advocates for a surgical team that performs more like the 1980 hockey team than the 2004 dribbling dream team. Correspondence: Dr Pronovost, Departments of Anesthesiology and Critical Care Medicine and Health Policy, Johns Hopkins University School of Medicine, 1909 Thames St, 2nd Floor, Baltimore, MD 21231 (ppronovo@jhmi.edu). Financial Disclosure: Dr Pronovost has a grant from the Michigan Hospital Association to improve safety in surgery.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 2008

Keywords: nurses,surgeons,anesthesiologists,surgical checklist

There are no references for this article.