Two-Minute Pre-Op Meeting Curbs Surgical Errors

Short briefing to identify critical details should be a national standard, study suggests

MONDAY, Jan. 29, 2007 (HealthDay News) -- A two-minute meeting among members of surgical teams before an operation can cut the risk of performing surgery on the wrong part of the body or on the wrong patient, suggests a Johns Hopkins study.

"Although we lack systems for uniform reporting of wrong-site surgeries to understand the extent of the problem, we observed team meetings increase the awareness of OR personnel with regard to the site and procedure and their perceptions of operating rooms safety," noted study lead author Dr. Martin Makary, director of the Johns Hopkins Center for Surgical Outcomes Research.

He noted that "wrong-site" surgery is extremely rare. But it does occur and is preventable. One study of over 2.8 million operations conducted in Massachusetts over a 20-year period found the rate of wrong-site surgery to be about one in every 112,994 operations.

A standardized operating room briefing program became part of Hopkins Hospital policy in June 2006. For this study, researchers surveyed 147 surgeons, 59 anesthesiologists, 187 nurses and 29 other OR staff before and three months after the policy took effect.

During the two-minute briefing, all members of the OR team state their name and role, and the lead surgeon identifies and verifies critical details, including the patient's identity, the surgical site, and patient safety concerns. The briefing is conducted after the patient has been given anesthesia and prior to incision.

After training about presurgery briefings, 13.2 percent more of OR personnel said they believed the policy would be effective in reducing wrong-site errors, and more than 90 percent of the OR personnel agreed that "a team discussion before a surgical procedure is important for patient safety."

The study appears in the February issue of the Journal of the American College of Surgeons.

The Joint Commission, which evaluates and accredits about 15,000 U.S. health care organizations and programs, requires hospital OR personnel to have a pre-surgical conversation in the OR before every operation. However, the Joint Commission did not set a national standard.

"The Joint Commission identified communication breakdowns as the most common root cause of wrong-site surgeries. Our research indicates that OR personnel see pre-surgical briefings as a useful tool to help prevent such errors," Makary said.

More information

The U.S. Agency for Healthcare Research and Quality offers advice for patients who are having surgery.

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