Measuring briefing and checklist compliance in surgery: a tool for quality improvement

Operating room briefings improve patient outcomes; however, implementation and methods to measure are lacking. A briefing audit tool was developed with 4 domains: briefing logistics, briefing basics, specific briefing content, and briefing participation. The tool evaluated preoperative briefings across surgical services at an academic medical center. Sixty-three preoperative briefings were observed. Introduction by name and role occurred in 15% of cases. There was a wide variation in discussion of the critical goals of the surgical procedure among services D (100%), A (26%), B (19%), and C (0%). Participation in the briefing was variable among stakeholders and between services. Verbal contributions were variable across all roles ranging from 65% (surgeons) to 11% (trainees and surgical technologist). Preoperative briefing compliance is variable. Deficiencies varied between service lines, possibly highlighting the need for service-specific customization of the briefing tool in surgery. This tool is a practical method for the study of briefing implementation.