Use of an electronic documentation module to improve surgical debriefing effectiveness

Area of Science:

• Healthcare quality improvement
• Surgical communication strategies
• Patient safety research

Background:

• Effective operating room communication is vital for patient safety and outcomes.
• Structured debriefing tools enhance team coordination and address safety concerns.
• The COVID-19 pandemic presented challenges to in-person training and resource allocation for surgical debriefings.

Purpose of the Study:

• To evaluate an electronic health record-based approach for documenting surgical debriefings and closing identified issues.
• To assess the impact of this intervention on debriefing incidence, perceived effectiveness, and communication loop closure.
• To adapt surgical debriefing practices under pandemic-related constraints.

Main Methods:

• A longitudinal, repeated-measures quality improvement study utilizing a new electronic health record module for debriefing documentation.
• Surveys were administered to assess perceptions of the debriefing process.
• Data collected from 56 operating rooms across 3 hospital towers over 3 years (ending December 2023) using 4 Plan-Do-Study-Act cycles.

Main Results:

• Surgical debriefing incidence increased by 111%, reaching 88% by the final year.
• Post-intervention surveys showed increased perceived effectiveness of debriefings (52% vs. 38%, P=.02).
• Frequency of discussing equipment issues (87% vs. 75%, P=.008) and loop closure (46% vs. 34%, P=.03) significantly increased, with greater leadership involvement.

Conclusions:

• The electronic health record-integrated debriefing system successfully increased debriefing incidence and perceived effectiveness.
• The intervention improved communication loop closure and positively impacted team communication despite pandemic challenges.
• This approach demonstrates a sustainable method for enhancing surgical safety communication in resource-constrained environments.