April 29, 2005
HOUSTON - Patient safety is a top priority at the Michael E. DeBakey VA Medical Center (MEDVAMC). The Operative Care Team is leading the way through Medical Team Training, creating an environment to enhance communication among clinicians.
Collaboration and good communication in medicine is proven to enhance patient safety and quality of care. “It has been shown that failures in communication lead to medical errors. The purpose of the training instituted here at the Michael E. DeBakey VA Medical Center is to empower all members of a patient’s health care team. We want each to speak candidly in the operating room to identify potential problems. Our goal is improved communication between providers,” said David H. Berger, M.D., Operative Care Line executive.
By creating an environment where operating room team members communicate effectively using a number of tools, such as assertiveness and rules of conduct, patient safety and quality of care are enhanced. “It’s all about the patient and improving communication among team members. Promotion of patient safety is a key component,” said Beverly Green-Rashad, Operative Care Line nurse executive.
Berger and Green-Rashad developed a Pre-Operative Briefing Checklist for use in the operating room setting. “This is a very effective and inexpensive process to implement,” said Berger. “It improves communication so that patient safety issues are covered before the surgery begins.”
The checklist is reviewed in the operating room while the patient is still awake. The steps call for the surgery team to:
STEP 1: Discuss with the patient the procedure and body part to be operated on.
STEP 2: Review the patient's medication history.
STEP 3: Review and administer appropriate prophylactic antibiotics to prevent surgical site infections.
STEP 4: Ensure proper positioning of the patient.
STEP 5: Review special equipment, such as implants and blood products, required during surgery.
STEP 6: Discuss potential anesthesia issues, such as changes in blood pressure, that may prevent the anesthesia from working properly.
Communication is further enhanced in the operating room by the use of a white board listing all the names of the surgical team members and other important factors related to the procedure. With education and training, all team members now feel they have the power to speak up when they see a problem.
“The interaction and communication between the surgeon and anesthesiologist are greatly improved. This definitely enhances patient safety,” said Salwa Shenaq, M.D., Anesthesiology Service executive.
To conclude the surgery procedure, a brief meeting is held afterwards to reflect on what happened and to discuss any needed improvements. The goal is to maximize learning from a recent experience.
“At the Michael E. DeBakey VA Medical Center, we are always trying to improve patient safety and communication among caregivers,” said Green-Rashad.