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Briefings – What Can Surgical and Minimally Invasive Interventional Teams Learn From Airline Flight Deck Practice?

Published:November 09, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.11.006

      Abstract

      While healthcare should not be compared to aviation or indeed other high reliability organisations (HROs), there are many lessons, attitudes and transferable practices that can be applied, and more importantly adapted from them, to improve patient safety and team morale. The team brief before any interventional list is one such process that can have a significant effect on the delivery and safety of patient care and effective team working. Due to NHS pressures and the perception by some in healthcare that the time taken to conduct a full team briefing has little importance, it can sometimes be rushed or regarded as a ‘tick box’ process that delays a list. However, when used appropriately, the briefing is a chance to lower authority gradients thereby improving patient safety. It also reduces the likelihood of medical errors, builds and improves situational awareness by considering various ‘what if?’ scenarios and how they will be dealt with, and consider wider issues including potential distractions. An important outcome is also its effect on team morale through empowerment as well as an opportunity for learning.
      In this article, which has been written following a unique opportunity to observe a full team brief on an Airbus A380 flight deck, we consider how using checklists thoroughly, briefings can be used to best advantage for interventional teams. We raise the question ‘would you engage differently with the briefing if your own life or procedure depended on it?’

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      References

        • Timmons S.
        • Baxendale B.
        • Buttery A.
        • et al.
        Implementing human factors in clinical practice.
        Emerg Med J. 2015; 32: 368-372
        • Ricci M.
        • Panos A.L.
        • Lincoln J.
        • et al.
        Is aviation a good model to study human errors in health care?.
        Am J Surg. 2012; 203: 798-801
        • Allard J.
        • Bleakley A.
        • Hobbs A.
        • et al.
        Pre-surgery briefings and safety climate in the operating theatre.
        BMJ Qual Saf. 2011; 20: 711-717
      1. Kennedy I. The report of the public inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984–1995: learning from Bristol. Final Report 2001 Government Document CM 5207/1.

        • Brennan P.A.
        Davidson M Improving patient safety: we need to reduce hierarchy and empower junior doctors to speak up.
        BMJ. 2019; 366: I14461
        • Quine L.
        Workplace bullying in NHS community trust: staff questionnaire survey.
        BMJ. 1999; 318: 228-232
      2. Rabol LI, McPhail A, Ostergaard D, et al. Promoters and barriers in hospital team communication. A focus group study. J Commun Healthc. 5: 129-139.

        • Green B.
        • Oeppen R.S.
        • Smith D.W.
        • et al.
        Challenging hierarchy in healthcare teams - ways to flatten gradients to improve teamwork and patient care.
        Br J Oral Maxillofac Surg. 2017; 55: 449-453
        • Green B.
        • Mitchell D.A.
        • Stevenson P.
        • et al.
        Leading article: how can I optimise my role as a leader within the surgical team?.
        Br J Oral Maxillofac Surg. 2016; 54: 847-850
        • Green B.
        • Parry D.
        • Oeppen R.S.
        • et al.
        Situational awareness - what it means for clinicians, its recognition and importance in patient safety.
        Oral Dis. 2017; 23: 721-725
        • Brennan P.A.
        • Davidson M.
        • Knighton J.
        • et al.
        Looking after ourselves at work – the importance of being hydrated and fed.
        BMJ. 2019; 364: I528
        • Hardie J.
        • et al.
        Patient, Procedure, People (PPP): Recognising & responding to intra-operative critical events.
        Ann Roy Coll Surg Eng. 2022; 109: 409-413
        • Gillespie B.M.
        • Harbeck E.
        • Kang E.
        • et al.
        Correlates of non-technical skills in surgery: a prospective study.
        BMJ Open. 2017; 30: e014480
        • Westbrook J.I.
        • Raban M.Z.
        • Walter S.R.
        • et al.
        Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.
        BMJ Qual Saf. 2018; 27: 655-663
        • Mentis H.M.
        • Chellali A.
        • Manser K.
        • et al.
        A systematic review of the effect of distraction on surgeon performance: directions for operating room policy and surgical training.
        Surg Endosc. 2016; 30: 1713-1724
        • Sevdalis N.
        • Undre S.
        • McDermott J.
        • et al.
        Impact of intraoperative distractions on patient safety: a prospective descriptive study using validated instruments.
        World J Surg. 2014; 38: 751-758
        • Mahadevan K.
        • Cowan E.
        • Kalsi N.
        • et al.
        Distractions in the cardiac catheterisation laboratory: impact for cardiologists and patient safety.
        Open Heart. 2020; 7: e001260
        • Antoniadis S.
        • Passauer-Baierl S.
        • Baschnegger H.
        • et al.
        Identification and interference of intraoperative distractions and interruptions in operating rooms.
        J Surg Res. 2014; 188: 21-29
        • Healey A.N.
        • Primus C.P.
        • Koutantji M.
        Quantifying distraction and interruption in urological surgery.
        Qual Saf Health Care. 2007; 16: 135-139
        • Wadhera R.K.
        • Parker S.H.
        • Burkhart H.M.
        • et al.
        Is the Sterile Cockpit concept applicable to Cardiovascular Surgery critical intervals or critical events? The impact of protocol driven communication during Cardiopulmonary Bypass.
        J Thorac Cardiovasc Surg. 2010; 139: 312-319