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Evaluation of a Preoperative Checklist and Team Briefing among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication
Archives of Surgery (2008)
  • Lorelei Lingard, University of Toronto
  • Glenn Regehr, University of Toronto
  • Beverley Orser, University of Toronto
  • Richard Reznick, University of Toronto
  • G. Ross Baker, University of Toronto
  • Diane Doran, University of Toronto
  • Sherry Espin, Ryerson University
  • John Bohnen, University of Toronto
  • Sarah Whyte, University of Toronto

OBJECTIVE: To assess whether structured team briefings improve operating room communication.

DESIGN, SETTING, AND PARTICIPANTS: This 13-month prospective study used a preintervention/postintervention design. All staff and trainees in the division of general surgery at a Canadian academic tertiary care hospital were invited to participate. Participants included 11 general surgeons, 24 surgical trainees, 41 operating room nurses, 28 anesthesiologists, and 24 anesthesia trainees.

INTERVENTION: Surgeons, nurses, and anesthesiologists gathered before 302 patient procedures for a short team briefing structured by a checklist. Main Outcome Measure The primary outcome measure was the number of communication failures (late, inaccurate, unresolved, or exclusive communication) per procedure. Communication failures and their consequences were documented by 1 of 4 trained observers using a validated observational scale. Secondary outcomes were the number of checklist briefings that demonstrated "utility" (an effect on the knowledge or actions of the team) and participants' perceptions of the briefing experience.

RESULTS: One hundred seventy-two procedures were observed (86 preintervention, 86 postintervention). The mean (SD) number of communication failures per procedure declined from 3.95 (3.20) before the intervention to 1.31 (1.53) after the intervention (P < .001). Thirty-four percent of briefings demonstrated utility, including identification of problems, resolution of critical knowledge gaps, decision-making, and follow-up actions.

CONCLUSIONS: Interprofessional checklist briefings reduced the number of communication failures and promoted proactive and collaborative team communication.

  • Anesthesiology,
  • Communication,
  • Evaluation Studies,
  • General Surgery,
  • Health Services Research,
  • Hospitals,
  • Teaching,
  • Interprofessional Relations,
  • Middle Aged,
  • Nursing,
  • Odds Ratio,
  • Ontario,
  • Operating Rooms,
  • Patient Care Team,
  • Probability,
  • Prospective Studies,
  • Safety Management,
  • Total Quality Management
Publication Date
January, 2008
Publisher Statement
Dr. Lorelei Lingard is currently a faculty member at The University of Western Ontario.
Citation Information
Lorelei Lingard, Glenn Regehr, Beverley Orser, Richard Reznick, et al.. "Evaluation of a Preoperative Checklist and Team Briefing among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication" Archives of Surgery Vol. 143 Iss. 1 (2008)
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