Original Article
The Role of the Operating Room Nurse Manager in the Successful Implementation of Preoperative Briefings and Postoperative Debriefings in the VHA Medical Team Training Program

https://doi.org/10.1016/j.jopan.2010.07.003Get rights and content

To improve communication within surgical teams, Veterans Health Administration (VHA) implemented a Medical Team Training Program (MTT) based on the principles of crew resource management. One hundred two VHA facilities were analyzed. Nursing leadership participation in the planning stages of the program was compared with outcomes at follow-up. Nurse manager participation in planning was associated with higher rates of implementation of preoperative briefing and postoperative debriefing. Nurse managers are a critical component in the planning phase of team training programs focused on OR clinical staff.

Section snippets

Materials and Methods

One hundred twenty-nine facilities underwent MTT during the national roll-out of the VHA MTT Program. This study includes 102 facilities (78% of total participants) that underwent medical team training between November 29, 2006, and April 29, 2009, in which complete preparation and planning records were available for review. The study was approved by the VHA Ann Arbor Research and Development Committee and Institutional Review Board.

The VHA MTT Program consists of three phases: (1) a

Results

The 102 facilities with evaluable preparation and planning data included close to 10,000 staff who underwent MTT (Table 1). The OR Nurse Manager participated in more preparation and planning conference calls than the Chiefs of Surgery or Anesthesiology. On average, OR Nurse Managers participated in two of the three planned calls in preparation for the briefings and debriefings project and learning session.

Facility engagement in the learning session was categorized as leadership involvement,

Discussion

Teamwork and communication problems are recognized causes of adverse events in the OR.1, 2, 3 The use of preoperative briefings guided by a checklist have been associated with improved teamwork and communication, fewer nontechnical and technical errors, and improved morbidity and mortality.4, 5, 6 Implementation of preoperative briefings and postoperative debriefings is the cornerstone of the VHA MTT program.7

The results of the current study demonstrate the success of the MTT program in the

Lori D. Robinson, MSN, RN, is Nurse Educator, Medical Team Training (MTT)

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Lori D. Robinson, MSN, RN, is Nurse Educator, Medical Team Training (MTT)

Douglas E. Paull, MD, is Co-Director MTT

Lisa M. Mazzia, MD, is Co-Director MTT

Lisa Falzetta, MS, RN, is Nurse Educator MTT

James Hay, MS, RN, is Nurse Educator MTT

Julia Neily, MS, MPH, RN, is Associate Director, White River Junction (WRJ) Field Office

Peter D. Mills, PhD, is Director, WRJ Field Office

Brian Carney, MD, is Patient Safety Physician, WRJ Field Office

James P. Bagian, MD, PE, is Chief Patient Safety Officer and Director, Veterans Health Administration National Center for Patient Safety, Ann Arbor, MI and White River Junction, VT.

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

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