Pre-surgery briefings and safety climate in the operating theatre

Allard, Jon; Bleakley, Alan; Hobbs, Adrian J.; Coombes, Lee

doi:10.1136/bmjqs.2009.032672

Cited by 68 publications

(64 citation statements)

References 44 publications

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“…Our findings are supported through other data. Individuals who report that they regularly engage in briefing also express a positive shift in attitudes to teamwork in comparison with those who report less contact with briefing (Allard et al 2011).…”

Section: Discussionmentioning

confidence: 98%

“…The genesis and development of our educational intervention have been reported elsewhere (for example Bleakley et al 2004;Allard et al 2007Allard et al , 2011, as have the effects of the first round of the intervention . In short, the intervention includes three strands: data-driven iterative education in human factors for all OT personnel; establishing a local, reactive close call (near miss) incident reporting system; and developing team self review (briefing and debriefing) across all surgical teams.…”

Section: Designmentioning

confidence: 99%

“…Building such collaborative capital is not easy -it demands a common will to democracy and the translation of that will into collaborative, patient-centred practices, such as pre-list briefing and post-list debriefing (Allard et al 2007(Allard et al , 2011.…”

Section: Climate Change Precedes and Forms Culture Changementioning

confidence: 99%

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Towards culture change in the operating theatre: Embedding a complex educational intervention to improve teamwork climate

2012

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Background: Changing teamwork climate in healthcare through a collective shift in attitudes and values may be a necessary precursor to establishing a positive teamwork culture, where innovations can be more readily embedded and sustained. A complex educational intervention was initiated across an entire UK Trust's surgical provision, and then sustained. Attitudes towards teamwork were measured longitudinally to examine if the intervention produced sustainable results. Aims: The research aimed to test whether sustaining a complex education intervention to improve teamwork would result in an incremental, longitudinal improvement in attitudes and values towards teamwork. The intervention's larger aim is to progress the historical default position of multi-professional work to authentic inter-professional teamwork, as a positive values climate translates in time into behavioural change defining a safety culture. Method: Attitudes were measured at three points across all surgical team personnel over a period of 4 years, using a validated Safety Attitudes Questionnaire with a focus on the 'teamwork climate' domain. Pre-and post-intervention 'teamwork climate' scores were compared to give a longitudinal measure as a test of sustainability. Results: Mean 'teamwork climate' scores improved incrementally and significantly following the series of educational interventions, showing that practitioners' valuing of teamwork activity can be improved and sustained. Conclusions: Longitudinal positive change in attitudes and values towards teamwork can be sustained, suggesting that a deliberate, designed complex intervention can shape a safety climate as a necessary prerequisite for the establishment of a sustainable safety culture.

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Section: Discussionmentioning

confidence: 98%

Section: Designmentioning

confidence: 99%

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Towards culture change in the operating theatre: Embedding a complex educational intervention to improve teamwork climate

2012

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“…The hospital theater department has engaged in a systematic program of quality improvement (QI) since 2008 influenced by the model developed by Langley et al 29,30 Daily safety huddles 31 and weekly safety meetings are used to coordinate QI activities. One strand of this QI project involves the monitoring and improvement of prelist briefing and checklist use.…”

Section: Setting and Contextmentioning

confidence: 99%

Incidence of Wrong-Site Surgery List Errors for a 2-Year Period in a Single National Health Service Board

Geraghty

Ferguson

McIlhenny³

et al. 2017

J Patient Saf

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Introduction Wrong-site/side surgical “never events” continue to cause considerable harm to patients, healthcare professionals, and organizations within the United Kingdom. Incidence has remained static despite the mandatory introduction of surgical checklists. Operating theater list errors have been identified as a regular contributor to these never events. The aims of the study were to identify and to learn from the incidence of wrong-site/side list errors in a single National Health Service board. Methods The study was conducted in a single National Health Service board serving a population of approximately 300,000. All theater teams systematically recorded errors identified at the morning theater brief or checklist pause as part of a board-wide quality improvement project. Data were reviewed for a 2-year period from May 2013 to April 2015, and all episodes of wrong-site/side list errors were identified for analysis. Results No episodes of wrong-site/side surgery were recorded for the study period. A total of 86 wrong-site/side list errors were identified in 29,480 cases (0.29%). There was considerable variation in incidence between surgical specialties with ophthalmology recording the largest proportion of errors per number of surgical cases performed (1 in 87 cases) and gynecology recording the smallest proportion (1 in 2671 cases). The commonest errors to occur were “wrong-side” list errors (62/86, 72.1%). Discussion This is the first study to identify incidence of wrong-site/site list errors in the United Kingdom. Reducing list errors should form part of a wider risk reduction strategy to reduce wrong-site/side never events. Human factors barrier management analysis may help identify the most effective checks and controls to reduce list errors incidence, whereas resilience engineering approaches should help develop understanding of how to best capture and neutralize errors.

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“…Enhanced cooperation among Or personnel correlates with reduced postoperative complications (7)(8)(9)(10) and mortality (9)(10)(11). Preoperative briefings also correlate with enhanced safety attitude (12). The quality of communication can be perceived differently by nurses and doctors (13), but with the use of the checklist, the communication failures are reduced (14).…”

Section: Introductionmentioning

confidence: 99%

Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications, and unplanned readmissions in a pilot study in neurosurgery

et al. 2013

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Background and Aims: the World health organization's surgical safety checklist is designed to improve adherence to operating room safety standards, and its use has been shown to reduce complications among surgical patients. the objective of our study was to assess the impact of the implementation of the checklist on safety-related issues in the operating room and on postoperative adverse events in neurosurgery.Material and Methods: from structured questionnaires delivered to operating room personnel, answers were analyzed to evaluate communication and safety-related issues during 89 and 73 neurosurgical operations before and after the checklist implementation, respectively. from the analyzed operations, 83 and 67 patients, respectively, were included in a retrospective analysis of electronic patient records to compare the length of hospital stay, reported adverse events, and readmissions. in addition, the consistency of operating room documentation and patient records was assessed.Results and Conclusions: communication between the surgeon and the anesthesiologist was enhanced, and safety-related issues were better covered when the checklist was used. unplanned readmissions fell from 25% to 10% after the checklist implementation (p = 0.02). Wound complications decreased from 19% to 8% (p = 0.04). the consistency of documentation of the diagnosis and the procedure improved. the use of the checklist improved safety-related performance and, contemporarily, reduced numbers of wound complications, and readmissions were observed.

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Pre-surgery briefings and safety climate in the operating theatre

Cited by 68 publications

References 44 publications

Towards culture change in the operating theatre: Embedding a complex educational intervention to improve teamwork climate

Towards culture change in the operating theatre: Embedding a complex educational intervention to improve teamwork climate

Incidence of Wrong-Site Surgery List Errors for a 2-Year Period in a Single National Health Service Board

Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications, and unplanned readmissions in a pilot study in neurosurgery

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