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Posted 30 Sep 2014 in Surgery

Approximately half of hospital adverse events relate to theatre procedures. Surgical complications and adverse outcomes have been linked to a lack of communication and coordination among surgical teams. These communication breakdowns may lead to team members being or feeling uninformed or misinformed. [1]

From April to September the Health Quality & Safety Commission’s Reducing Perioperative Harm programme has been the focus of the Open for better care patient safety campaign. The campaign has focused on promoting teamwork and communication as essential for achieving the goal of making patients safer in the operating theatre. Topics covered include the surgical checklist, briefing and debriefing and preventing venous thromboembolism (VTE). Links to the associated resources are provided below.

Behind the scenes the programme team has also been working with three proof of concept (PoC) pilot sites (Lakes DHB, Waikato DHB and Southern Cross Auckland) to test methods for ensuring appropriate and successful use of briefing, all three parts of the checklist and debriefing as tools to improve surgical teams’ teamwork and communication. This work has also included the development of an app to assist with measuring surgical teams’ levels of engagement and collecting data for the perioperative harm quality and safety marker. The work with the PoC sites will continue until December 2014 and the findings, including the app, will be made available to the wider sector soon after its conclusion.

The campaign resources provide tools and ideas for quality improvement teams to work with staff to improve teamwork and communication. These range from improvement activity toolkits to a range of teaching videos including a three-part surgical checklist video, the grand round presentation by Ian Civil, and two videos (surgical briefing and debriefing and implementing briefing and debriefing sessions) to support improved teamwork and communication in the operating theatre.

Perioperative harm resources

We now have 25 perioperative harm champions (at least one per DHB, with some DHBs having two) who have taken on the challenge of improving communication and team work in the operating theatre over the course of the campaign. It is hoped that these champions will continue to work with the Commission’s Reducing Perioperative Harm programme to carry on the good work that’s been started via the campaign.

Counties Manukau theatre team celebrates perioperative harm launch.Our champions have also organised and led activities ranging from campaign launch days to video competition entries and education days.


  1. Einav, Y. et al. (2010). Preoperative Briefing in the Operating Room: Shared Cognition, Teamwork, and Patient Safety, Chest, 137(2), 443–449.