Improving the Quality of Team Communication through Coaching

Purpose:
To evaluate coaching as an intervention to improve the quality of briefings and debriefings occurring in the operating room.

Background/Significance:
Communication among healthcare team members has become a major focus for many institutions. Breakdowns in communication have been identified as the root cause of many medical errors. Sentinel events occurring in surgery comprise a significant number of these events. Briefings and debriefings, utilizing the WHO surgical checklist, have been added to the operative routine to prevent communication breakdowns. Improving communication occurring during surgery should decrease the occurance of errors.

Methods:
A prospective study was conducted utilizing a pre/post intervention design. Observations were done to evaluate briefings and debriefings conducted in the operating rooms prior to and after the coaching intervention. Three hundred twenty total observations were completed. Trained observers were hired to evaluate the briefings and debriefings. The same observers conducted both sets of observations. Coaching was conducted by a retired faculty surgeon teaching crew resource management to the staff.

Results:
T-tests were utilized to evaluate the changes in communication during briefings and debriefings. The quality of briefings and debriefings displayed statistically significant improvement, (p .000), following the coaching intervention. In addition, there was improvement in communication action items such as handoffs, closed-loop communication, and verbalization of critical information.

Conclusions and Implications for Practice:
Improving communication in the hospital setting addresses the main cause of sentinel events making the setting safer for patients. Coaching was a successful intervention in addressing the quality of communication during the briefing and debriefing in the operating room.