Strengthening Patient Safety Through Improved Communication

Taking a few minutes so that members of the operating room team can ask questions and address concerns before and after surgeries has led to improved communication and teamwork, according to a study at Beaumont Hospital, Royal Oak.

"Sometimes the most common-sense solutions lead to major changes in the OR team that enhance patient safety and the quality of our work," says Robert Welsh, M.D., vice chief of Surgical Services for quality, safety and outcomes, and chief of thoracic (chest) surgery for Beaumont. "This practice has proved so valuable at our Royal Oak hospital that our Troy hospital soon started the same practice."

Details of the study are published in the August issue of The Joint Commission Journal on Quality and Patient Safety.

What it showed is that 90 percent of 40 caregivers who responded to a survey believe the pre-surgery briefings improved communication and teamwork. Overall, 69 percent of 39 caregivers who responded to a survey on the debriefings said they improved communication and 72 percent agreed they improved teamwork. Seventy percent of both groups said the briefings and debriefings are feasible given their current workload.

The preoperative communication briefings, launched at Beaumont, Royal Oak in 2006, were designed to ensure all surgical team members could comment on any aspect of a case and that all questions or concerns were addressed. This included the operative plan; patient risks; potential hazards; safety concerns; and knowledge of required equipment.

The postoperative debriefing reviewed concerns identified during the surgery regarding patient safety, quality and outcome. The surgical teams used a one-page briefing and debriefing worksheet as a tool.

From October 2006 to March 2008, staff conducted 37,133 briefings and debriefings.

The study was a collaborative effort. Beaumont partnered with the Michigan Health & Hospital Association's Keystone Center for Patient Safety & Quality; The Johns Hopkins University Quality and Safety Research Group; and Blue Cross Blue Shield of Michigan.

Surgeons at Beaumont Health System performed 79,577 surgeries in 2008. The hospitals are among the highest-volume surgical centers in the nation, according to the American Hospital Association.  Beaumont, Royal Oak is one of the nation's highest-volume hospitals for knee and hip replacements. The hospitals offer a full range of surgical services, from general surgery to 13 subspecialties, including bariatric (weight loss) surgery; cardiovascular surgery; neurosurgery; oral and maxillofacial surgery; orthopedic surgery; ophthalmologic surgery; otolaryngology; pediatric surgery; peripheral vascular surgery; plastic surgery; thoracic surgery; trauma surgery; and urologic surgery.