Transcript Document
MCIC Perioperative Initiative February 14, 2006 Operating Room Briefings Briefing Defined • A briefing is a discussion between two or more people, often a team, using succinct information pertinent to an upcoming event or procedure. What a Briefing does? 1. Map out the plan of care. 2. Identify Roles and Responsibilities for each team member . 3. Heightens awareness of the situation. 4. Allows the team to plan for the unexpected. 5. Team members needs, and expectations are met. Briefings Enhance Situational Awareness • Our ability to have the same understanding of what is occurring during the procedure, and to focus on: Preparation/ planning and vigilance Workload distribution Distraction Avoidance Effective Briefings Sets the tone for the day…… organized and efficient versus chaotic • • • • Encourages participation by all team members Owned by all team members Organized in thought regarding the procedure Establishes competence- who has what skills who performs what • Predicts what will happen later • Plans for the unexpected-Contingency Plan (include equipment, medications, consults) Communication Techniques • Use names, make introductions. • Make “eye contact” with all members of the team. • Clear and concise language • Active listening. • Positive nonverbal-approachable, open. When to Conduct Briefings Prior to any procedure. Beginning of the Day- Morning Briefing (separate tool) Situational – change in patient status results in deviation from the plan of care Reporting-off- breaks, shift change Consider Briefings –Fatigue or Staffing Challenges –New or change in Team Members –Experienced and Novices working side-by-side –Cultural differences The OR Briefing 1. Introduction of First names and Roles 2. TIME OUT- Review Critical Information □ Do we have the correct patient? □ Is the correct side or site marked? □ Has procedure been agreed upon? □ Have antibiotics been given? Surface and Mitigate Hazards Nursing- Discuss all relevant issues: • Are all the necessary instruments available? • Will any specific equipment be considered/needed? • Plans for break ( New nurse should introduce themselves upon switching) Surface and Mitigate Hazards Surgery- Discuss plan for the surgical procedure: • Describe critical steps • Provide the team with pertinent information, including problems that may be encountered. • Ask team: If something were to go wrong with this procedure, how could we prevent harm? • Ask Team: Does everyone know how to use the equipment? Surface and Mitigate Hazards Anesthesiology- Discuss all relevant issues: • Patient comorbid disease that will increase risk. • Aspects of surgery that increase that risk. • Availability of Blood Products? • Interventions to prevent complications such as myocardial infarction or surgical site infection. END of Briefing • Surgeon states: “If anyone has a concern during the case, please let me know.” Briefing-Simplicity in Signing-out: The Tool: Why is this patient here? What are the key issues with this patient? What am I most worried about? Tools for Team Use • AM OR Suite Briefing – Structured tool to assist anesthesia coordinator and charge nurse to anticipate problems, increase efficiency and improve patient flow • Debriefing Tool – Facilitates learning from factors that positively or negatively impacted complications or adverse events in a specific case • Shadowing Tool – Provides structured approach to identify communication and collaboration patterns to be improved