Implementation of Surgical Debriefing in Gynecologic Surgery [04F]

Abstract

INTRODUCTION: The surgical debrief is a standardized checklist performed near the conclusion of a surgery, similar to the pre-procedure “Time Out.” This surgeon lead debrief confirms correct procedures and specimens, addresses anesthesia concerns, patient disposition, and allows all team members to participate in discussions regarding case efficiency. It has been studied in several surgical fields and shown to improve operating room safety and communication, increase efficiency, and decrease morbidity. It also provides opportunities for educational feedback in academic institutions. The surgical debrief has not been studied in gynecologic surgery. This study evaluates the implementation of a standardized surgical debrief at a teaching hospital. METHODS: This is a quality improvement study using PDSA (plan-do-study-act) cycles to implement surgical debriefs in all gynecologic surgeries performed at this hospital. All OR team members took pre/post implementation surveys regarding OR safety and communication and received surgeon lead education regarding implementation protocols. IRB approval was obtained. RESULTS: In PDSA cycle 1, 59% (33/56) of eligible gynecologic surgeries completed debriefs. In PDSA cycle 2, debriefs were completed in 70% (40/57) of eligible gynecologic surgeries. Immediate resident feedback occurred in 46% of the cases that completed debriefs. CONCLUSION: The surgical debrief was successfully implemented into gynecologic surgery. Anonymous survey results by the vast majority of OR personnel felt the debrief enhanced OR safety, improved communication, and prompted immediate resident feedback in such a positive way, that it has been adopted routinely for all cases, amongst all surgical specialties at this institution.