The Association of VA SurgeonsPredictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training
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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Decreasing 30-day surgical mortality in a VA Medical Center utilizing the ACS NSQIP Surgical Risk Calculator
2017, Journal of Surgical ResearchCitation Excerpt :A key tenant in quality improvement literature is that the focus of improving the quality of care for patients is to design and implement system level strategies, rather than blaming or targeting individuals. Also, our success implementing this intervention was helped by the support of the facility leadership and commitment of our surgical staff, which the literature has shown to be key in systems redesign.28,29 Implementation of a preoperative risk stratification intervention integrating a novel use of the ACS Surgical Risk Calculator as a screening tool with a multidisciplinary Pre-Operative Committee can be successfully accomplished as part of wide-spread systems level initiative to improve surgical quality and decrease mortality.
Huddles and Debriefings: Improving Communication on Labor and Delivery
2017, Anesthesiology ClinicsHuman Factors and Human Nature in Cardiothoracic Surgery
2016, Annals of Thoracic SurgeryCitation Excerpt :Minimizing complexity and grounding protocols in the realities of the specific workplace environment (accounting for the clinical needs and providers’ biases) are important considerations in designing checklists and briefing protocols [37, 55]. Methods to overcome provider resistance and optimize dissemination involve active leadership, deliberate enrollment, training and coaching, and ongoing feedback [37, 40, 41, 46, 56]. As with protocols developed for team training and crew resource management, the use of checklists and briefings must be monitored to ensure that their use is sustained and that they ultimately improve outcomes [13, 31, 33, 57, 58].
Sustainable, effective implementation of a surgical preprocedural checklist: An "attestation" format for all operating team members
2014, Joint Commission Journal on Quality and Patient SafetyImproving operating room efficiency, part 2: Intraoperative and postoperative strategies
2015, JBJS ReviewsCitation Excerpt :The Veterans Health Administration (VHA) National Center for Patient Safety implemented the Medical Team Training Program to improve patient safety and operating room efficiency with checklist-driven preoperative briefings and postoperative debriefings57. The same authors also reported that strong organizational support and facility leadership are major predictors of program success57. Similarly, an electronic postoperative team debriefing system using input from all team members prior to leaving the operating room was found to stimulate an effective “after-action” discussion58.