18 August 2014

JAMA Report Recommends OR Briefings to Reduce Errors

The operating room has been called the “revenue engine” of the hospital – at some facilities, OR services can contribute 60 to 70% of hospital revenues. However, according to the Journal of Patient Safety, 400,000+ people each year die from preventable medical errors - many of them in the OR. Last month, the Journal of the American Medical Association (JAMA) released a recommendation on ways to improve the safety and quality of care in an operating room: institute a standard briefing and debriefing process. An effective briefing can be performed in less than 2 minutes and can ultimately reduce delays by more than 80%, leading to hospital cost savings.

In a previous blog post, we discussed some of the obstacles hospital administrators may face when trying to institute hospital process improvements: 

  • Resistance to changefrom physicians and OR staff
  • Concerns about the added time
  • Hierarchy of a typical operating room.

Strategies to address these obstacles can be found here, but JAMA’s report is clear on the benefits of perioperative briefings:

  • Increased team communication
  • Fewer disruptions to surgical workflow
  • Improved overall perceptions about the safety climate in the OR

To conduct an effective briefing, follow these steps:

  1. Have team members introduce themselves by name and role
  2. Take a “time out” to focus on the case at hand without distractions
  3. Ask the anesthesiologist, surgeon, and nursing staff to provide a formal review.

A briefing process is also one of the key aspects of crew resource management (CRM), a strategy used by many hospitals to prevent OR errors. For more information on CRM, check out this blog post or download our paper on crew resource management, titled “Reducing Human Error in the Operating Room.”