The Impact of Briefing and Debriefing in Operating Room

Abstract Description

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Authors (including presenting author) :

Wong TK(1)(2), ChengCP(1)(2), Lau CW (1)(2), Lam KM(1)(2)

Affiliation :

(1)Department of Anaesthesia (2)Tuen Mun Hospital

Introduction :

Safety culture, a component of organization culture, is the shared beliefs, attitudes, values, norms and behavioral characteristics of employees. Previous studies have shown that preoperative briefings and postoperative debriefings, as guided by a standardized checklist, improved communication and performance. Currently, Briefing - debriefings huddle is not a common practice in operating suites of hospitals in Hong Kong.

Objectives :

This is a single centre prospective interventional study to investigate on whether a Briefing – Debriefing- Huddle would post a significant effect on the safety culture of operation room staff.

Methodology :

We employed the Safety Attitude Questionnaire in operating room (SAQ) to measure the safety culture of the involved staff (Anesthetists, Surgeons and Nurses). The first set of questionnaire was distributed prior to the introduction of the Briefing and Debriefing huddle in 2014. Standardized Briefing and debriefing sessions for elective operations were then implemented. The second set of questionnaire was distributed two years after the establishment of the huddle.

Result & Outcome :

A total of 184 questionnaires were returned during the first administration with a response rate of 88.8%. In the follow-up study, 162 questionnaires were collected and the response rate was 79.4%. The ratio of doctor to nurse respondent ratio was approximately 1:1 in both administrations. Concerning the internal consistency of the questionnaire, the Cronbach’s alpha values were above 0.6 in five out of six domains, including the ‘Teamwork climate’, ‘Safety climate’, ‘Job satisfaction’ and ‘Stress recognition’, and ‘Working condition’. We demonstrated a statistically significant improvement in SAQ scores in two of the abovementioned domains, namely ‘Team Climate’ (p < 0.001) and ‘Safety Climate’ (p = 0.007) after the implementation of the huddle. Respondents who joined the briefing showed a statistically higher SAQ score (p=0.038) in ‘Safety Climate’ than the absentees of the huddle. Conclusion: We found a significant positive change in terms of ‘Team Climate’ and ‘Safety Climate’ via the ‘Safety Attitude Questionnaire in Operating room’ two years post implementation of the Briefing and Debriefing Huddle. In particular, attendees to the huddle had a statistically significantly higher score in ‘Safety Climate’.