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The impact of a daily pre-operative surgical huddle on interruptions, delays, and surgeon satisfaction in an orthopedic operating room: a prospective study.

Jain AL, Jones KC, Simon J, Patterson MD - Patient Saf Surg (2015)

Bottom Line: Interruptions decreased in all categories including equipment, antibiotics, planned procedure and side.In this pilot study, a daily pre-operative huddle improved the flow of a surgeon's day and satisfaction and indirectly provided indications of safety benefits by decreasing the number of interruptions and delays.Further studies in other surgical specialties should be conducted due to the promising results.

View Article: PubMed Central - PubMed

Affiliation: Children's Hospital Medical Center of Akron, 590 Ridgecrest Rd, Akron, OH 44303 USA.

ABSTRACT

Background: The goal of this project was to implement a daily pre-operative huddle (briefing) for orthopedic cases and evaluate the impact of the daily huddle on surgeons' perceptions of interruptions and operative delays.

Methods: Baseline measurements on interruptions, delays, and questions were obtained. Then the daily pre-operative huddle was introduced. Surgeons completed a surgical outcomes worksheet for each day's cases. Outcomes evaluated were primarily interruptions and delays starting cases before and following introduction of the huddle.

Results: 19 baseline observations and 19 huddle-implemented observations of surgeon's days were assessed. Overall, surgeon satisfaction increased and fewer delays occurred after introduction of huddles. Interruptions decreased in all categories including equipment, antibiotics, planned procedure and side. Time required for a huddle was less than one minute per case.

Conclusions: In this pilot study, a daily pre-operative huddle improved the flow of a surgeon's day and satisfaction and indirectly provided indications of safety benefits by decreasing the number of interruptions and delays. Further studies in other surgical specialties should be conducted due to the promising results. Data was collected from three orthopedic surgeons in this phase; however, as a next step, data should be drawn from the rest of the orthopedic surgical team and other surgical subspecialties as well.

No MeSH data available.


Interruptions without surgical huddles. Legend:
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Fig5: Interruptions without surgical huddles. Legend:

Mentions: Figures 5 and 6 are Pareto charts representing the number of questions/interruptions during the surgeon’s day (outside of huddle) categorized by planned procedure and side, position, tourniquet, essential equipment, x-ray needs, antibiotics, nerve block, estimated blood loss, estimated length of procedure, and special considerations. Interruptions at baseline showed equipment and antibiotics as the most frequent categories, and planned procedure/side as the 4th most frequent cause of interruption. Following huddle implementation, equipment dropped to the 2nd most frequent cause of interruptions. Antibiotics and planned procedure dropped to the 4th and 6th most frequent cause of interruptions, respectively. The downward change in ranking of equipment interruptions has the potential to decrease delays and decrease instances of missing equipment for various procedures. The change in antibiotics may mean antibiotics are more likely to be given in the appropriate time frame thereby contributing to improving the surgical site infection rate. The change in planned procedure/side has the potential to minimize the cases where the wrong procedure is done or the wrong side is opened – an area where orthopedic surgeons are especially at high risk. Overall, with surgical huddles, the number of total interruptions decreased considerably (163 before to 35 after) and the number of questions per case (outside of huddle) was reduced by 77%.Figure 5


The impact of a daily pre-operative surgical huddle on interruptions, delays, and surgeon satisfaction in an orthopedic operating room: a prospective study.

Jain AL, Jones KC, Simon J, Patterson MD - Patient Saf Surg (2015)

Interruptions without surgical huddles. Legend:
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4336479&req=5

Fig5: Interruptions without surgical huddles. Legend:
Mentions: Figures 5 and 6 are Pareto charts representing the number of questions/interruptions during the surgeon’s day (outside of huddle) categorized by planned procedure and side, position, tourniquet, essential equipment, x-ray needs, antibiotics, nerve block, estimated blood loss, estimated length of procedure, and special considerations. Interruptions at baseline showed equipment and antibiotics as the most frequent categories, and planned procedure/side as the 4th most frequent cause of interruption. Following huddle implementation, equipment dropped to the 2nd most frequent cause of interruptions. Antibiotics and planned procedure dropped to the 4th and 6th most frequent cause of interruptions, respectively. The downward change in ranking of equipment interruptions has the potential to decrease delays and decrease instances of missing equipment for various procedures. The change in antibiotics may mean antibiotics are more likely to be given in the appropriate time frame thereby contributing to improving the surgical site infection rate. The change in planned procedure/side has the potential to minimize the cases where the wrong procedure is done or the wrong side is opened – an area where orthopedic surgeons are especially at high risk. Overall, with surgical huddles, the number of total interruptions decreased considerably (163 before to 35 after) and the number of questions per case (outside of huddle) was reduced by 77%.Figure 5

Bottom Line: Interruptions decreased in all categories including equipment, antibiotics, planned procedure and side.In this pilot study, a daily pre-operative huddle improved the flow of a surgeon's day and satisfaction and indirectly provided indications of safety benefits by decreasing the number of interruptions and delays.Further studies in other surgical specialties should be conducted due to the promising results.

View Article: PubMed Central - PubMed

Affiliation: Children's Hospital Medical Center of Akron, 590 Ridgecrest Rd, Akron, OH 44303 USA.

ABSTRACT

Background: The goal of this project was to implement a daily pre-operative huddle (briefing) for orthopedic cases and evaluate the impact of the daily huddle on surgeons' perceptions of interruptions and operative delays.

Methods: Baseline measurements on interruptions, delays, and questions were obtained. Then the daily pre-operative huddle was introduced. Surgeons completed a surgical outcomes worksheet for each day's cases. Outcomes evaluated were primarily interruptions and delays starting cases before and following introduction of the huddle.

Results: 19 baseline observations and 19 huddle-implemented observations of surgeon's days were assessed. Overall, surgeon satisfaction increased and fewer delays occurred after introduction of huddles. Interruptions decreased in all categories including equipment, antibiotics, planned procedure and side. Time required for a huddle was less than one minute per case.

Conclusions: In this pilot study, a daily pre-operative huddle improved the flow of a surgeon's day and satisfaction and indirectly provided indications of safety benefits by decreasing the number of interruptions and delays. Further studies in other surgical specialties should be conducted due to the promising results. Data was collected from three orthopedic surgeons in this phase; however, as a next step, data should be drawn from the rest of the orthopedic surgical team and other surgical subspecialties as well.

No MeSH data available.