Long-term effects of perioperative briefing and debriefing on team
climate: A mixed-method evaluation study
Abstract
Introduction: To evaluate the long-term (5 years) effects of
perioperative briefing and debriefing on team climate. We explored the
barriers and facilitators of the performance of perioperative briefing
and debriefing to explain its effects on team climate and to make
recommendations for further improvement of surgical safety tools.
Methods: A mixed-method evaluation study was carried out among surgical
staff at a tertiary care university hospital with 593-bed capacity in
the Netherlands. Thirteen surgical teams were included. Team climate
inventory and a standardised evaluation questionnaire were used to
measure team climate (primary outcome) and experiences with
perioperative briefing and debriefing (secondary outcome), respectively.
Thirteen surgical team members participated in a semi-structured
interview to explore barriers and facilitators of the performance of
perioperative briefing and debriefing. Results: The dimension
‘participative safety’ increased significantly 5 years after the
implementation of perioperative briefing and debriefing (p = 0.02 (95%
confidence interval 1.18–9.25)). Perioperative briefing and debriefing
was considered a useful method for improving and sustaining
participative safety and cooperation within surgical teams. The positive
aspects of briefing were that shared agreements made at the start of the
day and that briefing enabled participants to work as a team.
Participants were less satisfied regarding debriefing, mostly due to the
lack of a sense of urgency and a lack of a safe culture for feedback.
Briefing and debriefing had less influence on efficiency. Conclusions:
Although perioperative briefing and debriefing improves participative
safety, the intervention will become more effective for maintaining team
climate when teams are complete, irrelevant questions are substituted by
customised ones and when there is a safer culture for feedback.