Effects of perioperative briefing and debriefing on patient safety: a prospective intervention study

Abstract

Objectives: This study was carried out to improve patient safety in the operating theatre by the introduction of perioperative briefing and debriefing, which focused on an optimal collaboration between surgical team members.

Design: A prospective intervention study with one pretest and two post-test measurements: 1 month before and 4 months and 2.5 years after the implementation of perioperative briefing and debriefing, respectively.

Setting: Operating theatres of a tertiary care hospital with 875 beds in the Netherlands.

Participants: All members of five surgical teams participated in the perioperative briefing and debriefing.

Intervention: The implementation of perioperative briefing and debriefing from July 2012 to January 2014.

Primary and secondary outcomes: The primary outcome was changes in the team climate, measured by the Team Climate Inventory. Secondary outcomes were the experiences of surgical teams with perioperative briefing and debriefing, measured with a structured questionnaire, and the duration of the briefings, measured by an independent observer.

Results: Two and a half years after the introduction of perioperative briefing and debriefing, the team climate increased statistically significant (p≤0.05). Members of the five surgical teams strongly agreed with the positive influence of perioperative briefing and debriefing on clear agreements and reminding one another of the agreements of the day. They perceived a higher efficiency of the surgical programme with more operations starting on time and less unexpectedly long operation time. The perioperative briefing took less than 4 min to conduct.

Conclusions: Perioperative briefing and debriefing improved the team climate of surgical teams and the efficiency of their work within the operating theatre with acceptable duration per briefing. Surgical teams with alternating team compositions have the most benefit of briefing and debriefing.

Keywords: change management; quality in health care.

Figure 1

Perioperative briefing and debriefing card.

Figure 2

Mean TCI scores: overall, dimensions ‘participative safety’ and ‘vision’ at 1 month before and 4 months and 2.5 years after the implementation of the perioperative briefing and debriefing. TCI, Team Climate Inventory.

Figure 3

Experiences of the members of the five surgical teams with perioperative briefing and debriefing in 2014 (n=123) and 2016 (n=107).