Hildebrand, Emily A.

The adoptions of briefing and debriefing protocols have evolved from the Joint Commission’s initiative to improve communication and safety in the operating room. Briefing normally occurs prior to incision and is used to discuss and confirm critical information, while debriefing occurs during or after surgery. Debriefing provides a unique opportunity for individuals and teams to immediately reflect on their performance, allowing them to more easily identify errors and develop plans to improve their next performance. Studies have shown that using briefings and debriefings improve communication and teamwork. However, there is still much to learn about the value of both for surgical teams. This paper presents a robust methodology for examining and measuring the impacts of surgical team briefings and debriefings on teamwork. The methodology includes (1) audio/video recording the surgical care process, (2) prospective observations using a validated electronic data collection tool, (3) pre- and post-surgery surveys, and (4) individual surgical team member interviews. The current paper describes the methodology to obtain a robust and comprehensive data set for analyzing the impacts of briefing and debriefing on teamwork; the results of the surgeries recorded using this methodology will be presented in subsequent papers.

Briefings are suggested to be an important mechanism for establishing and maintaining cohesive teams. However, there is still much to learn about briefings and how best to design and implement them for surgical teams in the operating room. Currently, there are no formally recognized protocols or methodologies for conducting surgical team briefings. This research reports preliminary findings from an effort to develop a model of team briefings for gynecological surgical teams. Semi-structured interviews were conducted using techniques derived from Applied Cognitive Task Analysis (Millitello & Hutton, 1998) with thirteen surgical team members spanning six different roles including surgeon, surgical resident, registered nurse, certified surgical assistant, certified scrub technician, and anesthesia. Findings reveal that informational needs are consistent across the team but also vary by individual role, illustrating the importance of addressing all stakeholders in potential interventions. Implications for the development of a team briefing model are discussed.