Effects of structured intraoperative briefings on patient outcomes: multicentre before-and-after study.

Tschan, Franziska; Keller, Sandra; Semmer, Norbert K; Timm-Holzer, Eliane; Zimmermann, Jasmin; Huber, Simon A; Wrann, Simon; Hübner, Martin; Banz, Vanessa; Prevost, Gian Andrea; Marschall, Jonas; Candinas, Daniel; Demartines, Nicolas; Weber, Markus; Beldi, Guido (2021). Effects of structured intraoperative briefings on patient outcomes: multicentre before-and-after study. The British journal of surgery, 109(1), pp. 136-144. Wiley 10.1093/bjs/znab384

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BACKGROUND

Operations require collaboration between surgeons, anaesthetia professionals, and nurses. The aim of this study was to determine whether intraoperative briefings influence patient outcomes.

METHODS

In a before-and-after controlled trial (9 months baseline; 9 months intervention), intraoperative briefings were introduced in four general surgery centres between 2015 and 2018. During the operation, the responsible surgeon (most senior surgeon present) briefed the surgical team using the StOP? protocol about: progress of the operation (Status), next steps (Objectives), possible problems (Problems), and encouraged asking questions (?). Differences between baseline and intervention were analysed regarding surgical-site infections (primary outcome), mortality, unplanned reoperations, and duration of hospital stay (secondary outcomes), using inverse probability of treatment (IPT) weighting based on propensity scores.

RESULTS

In total, 8256 patients underwent surgery in the study. Endpoint data were available for 7745 patients (93.8 per cent). IPT-weighted and adjusted intention-to-treat analyses showed no differences in surgical-site infections between baseline and intervention (9.8 versus 9.6 per cent respectively; adjusted difference (AD) -0.15 (95 per cent c.i. -1.45 to 1.14) per cent; odds ratio (OR) 0.92, 95 per cent c.i. 0.83 to 1.15; P = 0.797), but there were reductions in mortality (1.6 versus 1.1 per cent; AD -0.54 (-1.04 to -0.03) per cent; OR 0.60, 0.39 to 0.92; P = 0.018), unplanned reoperations (6.4 versus 4.8 per cent; AD -1.66 (-2.69 to -0.62) per cent; OR 0.72, 0.59 to 0.89; P = 0.002), and fewer prolonged hospital stays (21.6 versus 19.8 per cent; AD -1.82 (-3.48 to -0.15) per cent; OR 0.87, 0.77 to 0.98; P = 0.024).

CONCLUSION

Short intraoperative briefings improve patient outcomes and should be performed routinely.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
07 Faculty of Human Sciences > Institute of Psychology > Work and Organisational Psychology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Semmer, Norbert Karl; Banz Wüthrich, Vanessa; Prevost, Gian Andrea; Marschall, Jonas; Candinas, Daniel and Beldi, Guido

Subjects:

600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology
300 Social sciences, sociology & anthropology
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1365-2168

Publisher:

Wiley

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

16 Dec 2021 11:21

Last Modified:

20 Dec 2021 00:14

Publisher DOI:

10.1093/bjs/znab384

PubMed ID:

34850862

BORIS DOI:

10.48350/161867

URI:

https://boris.unibe.ch/id/eprint/161867

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