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Posted 28 Aug 2014 in Surgery

A simple sticker-based auditing system has succeeded in making pre-surgical briefings the norm at Gisborne Hospital.

The auditing system was introduced to encourage all members of theatre teams to attend team briefings before the start of the elective surgical lists. Most team members accepted the importance of briefings, but some were slower to agree to take part.

Briefings ensure surgical team members know each other and understand each other’s roles, and give them time to discuss any questions or concerns about the day's surgical cases.

They are among the initiatives promoted as part of the reducing perioperative harm focus of Open for better care, the national patient safety campaign led by the Health Quality & Safety Commission.

Briefings at Gisborne Hospital theatres are scheduled for 8.20am, ten minutes before the start of the elective list and when the scrub nurse is ready for the first case.

To encourage all who are involved in surgery that day to attend briefings in the hospital’s three operating theatres, a form was posted in the main corridor outside each theatre.

If the briefing was completed, a green sticker was stuck to the form. If the briefing wasn’t completed, a red sticker was stuck to the form and the reason for the incomplete briefing was noted.

The results of the audits were passed on to theatre team leaders and the heads of department of each surgical area.

Initially teams that completed their briefing had an indicator placed outside their theatre.

After the implementation phase, it was decided that the first elective patient of the day could not be brought into the theatre until the brief had been performed. The form displayed outside the theatre recorded when surgery had been late to start, and the reason why.

There were some late starts at first, until team members learned they needed to arrive at the theatre in time to take part in the briefing.

Clinical nurse educator and quality coordinator Nicola Atwood says the simple interventions proved effective as the team didn’t want to see documented evidence that they were responsible for a briefing not being performed.

She says briefings have now become the norm rather than the exception. The results have included quicker turnaround times between patients, improved readiness among surgical teams for patients with any concerns, greater productivity and less overtime.

Gisborne Hospital theatre team

Theatre staff behind the simple idea to make pre-surgical briefings the norm at Gisborne Hospital. From left Clinical Nurse Coordinator Chrissy Aldridge, Clinical Nurse Educator and Quality Coordinator Nicola Atwood, Registered Nurse Mark Rowles and Team Leader Anaesthetist Technicians Wendy Dewstow. Wendy was heavily involved in the auditing process and data collection for the pre-surgical briefs.