mcic perioperative initiative february 14, 2006 operating room briefings
TRANSCRIPT
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MCIC Perioperative InitiativeMCIC Perioperative InitiativeFebruary 14, 2006February 14, 2006
Operating Room BriefingsOperating Room Briefings
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Briefing Defined
• A briefing is a discussion between two or more people, often a team, using succinct information pertinent to an upcoming event or procedure.
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What a Briefing does?
1. Map out the plan of care.
2. Identify Roles and Responsibilities for each team member .
3. Heightens awareness of the situation.
4. Allows the team to plan for the unexpected.
5. Team members needs, and expectations are met.
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Briefings Enhance Situational Awareness
• Our ability to have the same understanding of what is occurring during the procedure, and to focus on:
Preparation/ planning and vigilanceWorkload distributionDistraction Avoidance
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Effective Briefings
Sets the tone for the day…… organized and efficient versus chaotic
• Encourages participation by all team members• Owned by all team members• Organized in thought regarding the procedure• Establishes competence- who has what skills
who performs what
• Predicts what will happen later• Plans for the unexpected-Contingency Plan (include
equipment, medications, consults)
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Communication Techniques
• Use names, make introductions.
• Make “eye contact” with all members of the team.
• Clear and concise language
• Active listening.
• Positive nonverbal-approachable, open.
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When to Conduct Briefings
Prior to any procedure.
Beginning of the Day- Morning Briefing (separate tool)
Situational – change in patient status results in deviation from the plan of care
Reporting-off- breaks, shift change
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Consider Briefings
–Fatigue or Staffing Challenges–New or change in Team
Members–Experienced and Novices
working side-by-side–Cultural differences
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The OR Briefing
1. Introduction of First names and Roles
2. TIME OUT- Review Critical Information
□ Do we have the correct patient?
□ Is the correct side or site marked?
□ Has procedure been agreed upon?
□ Have antibiotics been given?
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Surface and Mitigate Hazards
Nursing- Discuss all relevant issues:
• Are all the necessary instruments available?
• Will any specific equipment be considered/needed?
• Plans for break ( New nurse should introduce themselves upon switching)
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Surface and Mitigate Hazards
Surgery- Discuss plan for the surgical procedure:• Describe critical steps• Provide the team with pertinent information,
including problems that may be encountered.• Ask team: If something were to go wrong with
this procedure, how could we prevent harm?• Ask Team: Does everyone know how to use the
equipment?
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Surface and Mitigate Hazards
Anesthesiology- Discuss all relevant issues:
• Patient comorbid disease that will increase risk.
• Aspects of surgery that increase that risk.
• Availability of Blood Products?
• Interventions to prevent complications such as myocardial infarction or surgical site infection.
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END of Briefing
• Surgeon states: “If anyone has a concern during the case, please let me know.”
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Briefing-Simplicity in Signing-out:
The Tool:
Why is this patient here?
What are the key issues with this patient?
What am I most worried about?
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Tools for Team Use
• AM OR Suite Briefing– Structured tool to assist anesthesia coordinator and charge
nurse to anticipate problems, increase efficiency and improve patient flow
• Debriefing Tool– Facilitates learning from factors that positively or
negatively impacted complications or adverse events in a specific case
• Shadowing Tool– Provides structured approach to identify communication
and collaboration patterns to be improved