Briefing and Debriefing in the Cardiac Operating Room. Analysis of Impact on Theatre Team Attitude and Patient Safety

Surgical technology and operating-room safety failures: a systematic review of quantitative studies

“…Total and equipment-related error changed with type of operation: the pooled results from the six studies of cardiac operations12 14 18 19 23 26 showed higher total and equipment problems compared with the five studies of miscellaneous general surgical procedures11 13 16 20 22 (for equipment error, cardiac surgery: 2.99 (range 1.7–4.1) vs general surgery: 0.79 (range 0.7–0.86); for total error, cardiac surgery: 18.45 (9.5–32.8) vs general surgery: 2.0 (0–5.9) (figure 3)).…”

Patient Safety in the Cardiac Operating Room: Human Factors and Teamwork

“…170 These interventions lead to increased patient and staff satisfaction and reduced mortality. [171][172][173][174][175] Standardization of critical interactions by use of protocols (eg, handoffs) improves the content and structure of information and increases participation 21,77,176,177 but is often met with ambivalence at best and hostility at worst. 45,178 Physicians typically overrate their nontechnical skills; downplay the effects of stress, fatigue, and disruptions; and view the imposition of checklists or guidelines as limiting their ability to provide individualized patient care, or as an insult to their intelligence and skill.…”

“…218 Briefings are associated with perceptions of reduced risk and with enhanced collaboration. 66 In one study, 176 participants commented after the briefing, "Your opinions seem to matter. You feel more valued," and, "Now people are willing to say when they are not happy.…”

“…63 The debriefing allows members of the medical team to assess what went well and what did not, to coalesce as a team, and to improve their performance in their next case. 176 Debriefings provide teams the opportunity to formulate future plans, develop and implement system improvements, and address areas of communication weakness. 215 Debriefing methods and implementation processes have been described previously.…”

Using a Checklist in Robotic‐Assisted Laparoscopic Radical Prostatectomy Procedures

“…The literature suggests the checklist system provides a cognitive aid to OR personnel and standardizes performance 17 . In addition, the use of a checklist in the OR can be effective in preventing human errors, improving situational awareness, and enhancing communication and teamwork, which has been shown to contribute to a safer environment and lead to more favorable surgical outcomes 3,6,7,16,18‐20 . However, vigorous training and appropriate preparation are needed for effective implementation, and champions are needed to sustain checklist use 21‐24 …”