Patient care in the OR is often stressful, and negative interactions between surgeons and nurses can adversely impact patient care. Team members may be afraid to speak up, even though doing so might prevent or correct a mistake. The Joint Commission has listed improving communication among caregivers as one of its National Patient Safety Goals for 2009.1
Current research notes the silent culture in the OR as a factor in adverse patient events. The preoperative briefing encourages open communication and dialogue with the goal of improving collaborative patient care and facilitating relationships within the operative team.
Communication is key
OR staff depend on communication to optimize their roles in helping the team function at the highest possible level. By taking time each morning (usually only 3 to 5 minutes) to preoperatively discuss the course of patient care in the OR, team functioning can be optimized and adverse events possibly avoided. This small fragment of time in which the surgeon briefs the team on the course of action for each patient allows the staff to be better prepared. These briefings can occur all at once for every patient during the day, or before each procedure depending on the specialty and variations in care for each procedure. The surgeon can discuss the plan of approach and other known mitigating factors in the procedure. The anesthesia provider may discuss the heparin dose and other medications to be given. The certified surgical technologist can inquire about needed instrumentation and about planned deviations from the usual procedure, and the perioperative nurse can discuss allergies and other findings from the history. The knowledge gained during these short interactions also includes expectations spelled out clearly and concisely.
Promoting an open atmosphere
Open interaction in a comfortable atmosphere also allows time for questions and responses. The leader of the briefing should also encourage everyone to voice any concerns. This means that everyone must accept their responsibility by speaking up when there's a question. Effective communication is facilitated through this open atmosphere. Adaptation to team needs through procedure-specific communication in the OR has the potential to improve team functioning and ultimately, promote quality patient care.
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