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DOI: 10.1055/s-0042-1742468
Improving Preoperative Communication and First Case On-Time Starts with the Surgical Flight Plan: A Pilot Study
Funding None.Abstract
Background Closed-loop communication is essential for managing a diverse surgical team. When new or unfamiliar members are present, as is common in shift-based perioperative care, challenges to effective communication can arise.
Methods We introduced the Surgical Flight Plan (SFP), a novel communication tool that informs surgical team members on procedural details in advance of surgery, at our tertiary academic center. The tool was made available in the electronic health record prior to surgery. The primary outcome assessed after application of the SFP was “patient-in-room to incision time.” The secondary outcome was “improvement of communication in surgical teams” as assessed by a standardized (10-item) preintervention survey and a follow-up postintervention survey, given 3 months later. Data were gathered using Redcap software and statistical analysis was performed using SAS 9.4, significance was set at p-value less than 0.05
Results Thirty-six first-start, operative plastic surgery cases were included for the analysis (20 pre- and 16 postintervention). The average time from patient-in-room to surgical time out were 59.15 and 48.69 minutes pre-/postintervention respectively (p < .0437). Sixty-one members of the surgical team responded to the survey, with the majority citing improved team communication.
Conclusion The SFP significantly improved first case on-time starts (FCOTS) and may improve surgical team communication, efficiency, safety, and overall patient care. Expanding the use of the instrument into other surgical specialties is needed to further validate its efficacy.
Publication History
Received: 16 June 2021
Accepted: 03 November 2021
Article published online:
23 February 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Roberts KH, Bea R. Must accidents happen? Lessons from high-reliability organizations. Acad Manage Perspect 2001; 15 (03) 70-78
- 2 Roberts KH, Rousseau DM. Research in nearly failure-free, high-reliability organizations: having the bubble. IEEE Trans Eng Manage 1989; 36 (02) 132-139
- 3 Kohn LT, Corrigan JM, Donaldson MS. Errors in health care: a leading cause of death and injury. In: To err is human: Building a safer health system. Washington, DC: National Academies Press (US); 2000
- 4 Bates DW, Singh H. Two decades since to err is human: an assessment of progress and emerging priorities in patient safety. Health Aff (Millwood) 2018; 37 (11) 1736-1743
- 5 Haynes AB, Weiser TG, Berry WR. et al; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009; 360 (05) 491-499
- 6 Gawande A. Checklist Manifesto: How to Get Things Right. Haryana, India: Penguin Books India; 2010
- 7 Ware C. Information visualization: perception for design. Morgan Kaufmann: 2019
- 8 Lupton E, Miller JA. eds. ABC's of the Bauhaus: The Bauhaus and Design Theory. New York, USA: Princeton Architectural Press; 1991
- 9 Cms.gov. 2020 Quality programs. Accessed July 15, 2020: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Programs
- 10 Cms.gov. 2020 NHE fact sheet. Accessed July 7, 2020: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet