176 - Engaging the Perioperative Team in the Briefing Component of Teamstepps Preoperatively Results in Clinical Improvement Through Increased Patient Safety, Teamwork, and Improved Communication
Description: As technology evolves and surgical procedures become more complex, the Perioperative Team’s communication of a patient’s anticipated surgical plan prior to the administration of anesthesia and the final “Time Out” is critical for patient safety. Harbor-UCLA Medical Center is an inner-city Level One trauma academic teaching hospital with 16 operating rooms. In a six-month retrospective chart review, there was a total of nine cases aborted intraoperatively prior to incision due to preoperative critical lab values and unavailable equipment and/or implants. Through stronger teamwork and optimized communication, an opportunity to reduce these preventable intraoperative cancellations was identified. Literature and patient data were reviewed by the Perioperative Team, which consisted of operating room nurses, surgical technicians, surgeons, anesthesiologists and residents, who then worked together to assess and identify causes to the problem and agree upon a solution. The solution was to provide a platform for the Perioperative Team to collaborate and discuss critical information pertaining to the anticipated case during a dedicated meeting utilizing a standardized Preoperative Briefing checklist tool. The original tool was implemented in April 2015 with anticipated outcomes that improve communication amongst the team; provide a standardized tool to communicate interdisciplinary concerns, anticipations, and exchange of critical patient care information; create accountability for each team member; and ultimately decrease the number of preventable intraoperative case cancellations. Utilizing the Plan-Do-Study-Act (PDSA) cycle, the Briefing Tool was studied after its initial implementation and areas of improvement were identified with subsequent revisions made. The outcome data demonstrates decreased intraoperative cancellations through improved interdisciplinary team-based communication. The implications of perioperative nursing were positively influenced through the empowerment of nursing staff to speak up and ask questions, as well as improvement of trust and respect.