The Association of VA Surgeons
Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training

Presented at the Association of VA Surgeons Annual Meeting, April 19–21, 2009, Cambridge, MA.
https://doi.org/10.1016/j.amjsurg.2009.07.008Get rights and content

Abstract

Background

The purpose of this study was to examine which factors at a medical team training learning session predict future success in the implementation of preoperative briefings and postoperative debriefings at health care facilities.

Methods

A Likert score rating for physician involvement, leadership support, and composition of the implementation team was recorded for 64 VHA facilities at the time of a learning session by 3 medical team training educators. At a mean follow-up period of 8.2 months (standard error, .4 mo), a briefing score was established from quarterly semistructured interviews with the facility's implementation team.

Results

In a multivariable regression, leadership involvement at the time of the learning session was the best predictor of future briefing/debriefing success (R = .34, P = .03).

Conclusions

Full implementation of the patient safety tool preoperative briefings and postoperative debriefings is dependent on facility leadership support.

Section snippets

Materials and Methods

Sixty-four consecutive facilities undergoing medical team training between December 5, 2006, and June 4, 2008, were included in this study. The study (2008-040259) was approved by the VHA Ann Arbor Research and Development Committee.

During the preparation and planning phase, a facility implementation team worked closely with a nurse educator from the NCPS. Implementation teams included leaders (eg, Chief of Surgery, Nurse Manager) as well as frontline providers. During 3 conference calls, the

Results

Sixty-four consecutive VHA facilities enrolled in the Medical Team Training Program were examined. All facilities had 8 weeks of preparation and planning. Learning sessions involved an average audience of 88.5 participants (SE, 6.4 participants). Follow-up semistructured interviews and coaching were conducted quarterly for an average of 8.2 months (SE, .4 mo) at the time of this analysis.

Table 1 shows data from the FAT. Facilities were grouped into those conducting a preoperative

Comments

Communication failure and teamwork breakdown are leading causes of adverse events in health care, including those errors occurring in the operating room.6, 7 Medical team training improves patient safety and outcomes in the operating room.8, 9, 10, 11 The goals of the VHA Medical Team Training Program are to improve communication and teamwork in the operating room, leading to enhanced patient outcomes, better staff morale, and a change in the patient safety culture. Preoperative briefings and

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