Inadequate Preoperative Team Briefings Lead to More Intraoperative Adverse Events

Area of Science:

• Surgical Safety
• Healthcare Management
• Patient Outcomes

Background:

• The World Health Organization checklists have improved surgical safety, but the specific impact of preoperative briefings on intraoperative adverse events remains under-assessed.
• Preoperative briefings are crucial for team coordination and patient safety, yet their effectiveness in preventing adverse events requires further investigation.

Purpose of the Study:

• To assess the association between the quality of preoperative briefings and the occurrence of intraoperative adverse events (minor, potentially major, and major).
• To evaluate the impact of implementing changes following an initial assessment of preoperative briefing practices on adverse events and team familiarity.

Main Methods:

• A prospective case-control study conducted in two phases.
• Phase 1 involved auditing trauma and orthopedic surgical lists to collect data on preoperative briefings and intraoperative adverse events.
• Phase 2 repeated the audit after staff re-education and policy changes to assess the impact of improvements.

Main Results:

• In Phase 1, adequate preoperative briefings occurred in only 24% of lists, with significant associations between inadequate/incomplete briefings and intraoperative adverse events (P < 0.01).
• Following interventions in Phase 2, adequate briefings increased to 81%, and adverse events decreased to 3 (P = 0.01).
• Team familiarity also significantly improved with better preoperative briefings (P = 0.02).

Conclusions:

• Inadequate preoperative briefings are directly associated with an increase in minor adverse events and negatively impact team familiarity.
• Thorough and consistent preoperative briefings are essential for minimizing intraoperative adverse events and enhancing team cohesion in surgical units.
• The study recommends the universal implementation of comprehensive preoperative briefings in all surgical settings to improve patient safety and team performance.