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No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study

BACKGROUND: The team timeout (TTO) is a safety checklist to be performed by the surgical team prior to incision. Exchange of critical information is, however, important not only before but also during an operation and members of surgical teams frequently feel insufficiently informed by the operating...

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Autores principales: Timm-Holzer, Eliane, Tschan, Franziska, Keller, Sandra, Semmer, Norbert K., Zimmermann, Jasmin, Huber, Simon A., Hübner, Martin, Candinas, Daniel, Demartines, Nicolas, Weber, Markus, Beldi, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338924/
https://www.ncbi.nlm.nih.gov/pubmed/37457099
http://dx.doi.org/10.3389/fpsyg.2023.1195024
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author Timm-Holzer, Eliane
Tschan, Franziska
Keller, Sandra
Semmer, Norbert K.
Zimmermann, Jasmin
Huber, Simon A.
Hübner, Martin
Candinas, Daniel
Demartines, Nicolas
Weber, Markus
Beldi, Guido
author_facet Timm-Holzer, Eliane
Tschan, Franziska
Keller, Sandra
Semmer, Norbert K.
Zimmermann, Jasmin
Huber, Simon A.
Hübner, Martin
Candinas, Daniel
Demartines, Nicolas
Weber, Markus
Beldi, Guido
author_sort Timm-Holzer, Eliane
collection PubMed
description BACKGROUND: The team timeout (TTO) is a safety checklist to be performed by the surgical team prior to incision. Exchange of critical information is, however, important not only before but also during an operation and members of surgical teams frequently feel insufficiently informed by the operating surgeon about the ongoing procedure. To improve the exchange of critical information during surgery, the StOP?-protocol was developed: At appropriate moments during the procedure, the leading surgeon briefly interrupts the operation and informs the team about the current Status (St) and next steps/objectives (O) of the operation, as well as possible Problems (P), and encourages questions of other team members (?). The StOP?-protocol draws attention to the team. Anticipating the occurrence of StOP?-protocols may support awareness of team processes and quality issues from the beginning and thus support other interventions such as the TTO; however, it also may signal an additional demand and contribute to a phenomenon akin to “checklist fatigue.” We investigated if, and how, the introduction of the StOP?-protocol influenced TTO quality. METHODS: This was a prospective intervention study employing a pre-post design. In the visceral surgical departments of two university hospitals and one urban hospital the quality of 356 timeouts (out of 371 included operation) was assessed by external observers before (154) and after (202) the introduction of the StOP?-briefing. Timeout quality was rated in terms of timeout completeness (number of checklist items mentioned) and timeout quality (engagement, pace, social atmosphere, noise). RESULTS: As compared to the baseline, after the implementation of the StOP?-protocol, observed timeouts had higher completeness ratings (F = 8.69, p = 0.003) and were rated by observers as higher in engagement (F = 13.48, p < 0.001), less rushed (F = 14.85, p < 0.001), in a better social atmosphere (F = 5.83, p < 0.016) and less noisy (F = 5.35, p < 0.022). CONCLUSION: Aspects of TTO are affected by the anticipation of StOP?-protocols. However, rather than harming the timeout goals by inducing “checklist fatigue,” it increases completeness and quality of the team timeout.
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spelling pubmed-103389242023-07-14 No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study Timm-Holzer, Eliane Tschan, Franziska Keller, Sandra Semmer, Norbert K. Zimmermann, Jasmin Huber, Simon A. Hübner, Martin Candinas, Daniel Demartines, Nicolas Weber, Markus Beldi, Guido Front Psychol Psychology BACKGROUND: The team timeout (TTO) is a safety checklist to be performed by the surgical team prior to incision. Exchange of critical information is, however, important not only before but also during an operation and members of surgical teams frequently feel insufficiently informed by the operating surgeon about the ongoing procedure. To improve the exchange of critical information during surgery, the StOP?-protocol was developed: At appropriate moments during the procedure, the leading surgeon briefly interrupts the operation and informs the team about the current Status (St) and next steps/objectives (O) of the operation, as well as possible Problems (P), and encourages questions of other team members (?). The StOP?-protocol draws attention to the team. Anticipating the occurrence of StOP?-protocols may support awareness of team processes and quality issues from the beginning and thus support other interventions such as the TTO; however, it also may signal an additional demand and contribute to a phenomenon akin to “checklist fatigue.” We investigated if, and how, the introduction of the StOP?-protocol influenced TTO quality. METHODS: This was a prospective intervention study employing a pre-post design. In the visceral surgical departments of two university hospitals and one urban hospital the quality of 356 timeouts (out of 371 included operation) was assessed by external observers before (154) and after (202) the introduction of the StOP?-briefing. Timeout quality was rated in terms of timeout completeness (number of checklist items mentioned) and timeout quality (engagement, pace, social atmosphere, noise). RESULTS: As compared to the baseline, after the implementation of the StOP?-protocol, observed timeouts had higher completeness ratings (F = 8.69, p = 0.003) and were rated by observers as higher in engagement (F = 13.48, p < 0.001), less rushed (F = 14.85, p < 0.001), in a better social atmosphere (F = 5.83, p < 0.016) and less noisy (F = 5.35, p < 0.022). CONCLUSION: Aspects of TTO are affected by the anticipation of StOP?-protocols. However, rather than harming the timeout goals by inducing “checklist fatigue,” it increases completeness and quality of the team timeout. Frontiers Media S.A. 2023-06-29 /pmc/articles/PMC10338924/ /pubmed/37457099 http://dx.doi.org/10.3389/fpsyg.2023.1195024 Text en Copyright © 2023 Timm-Holzer, Tschan, Keller, Semmer, Zimmermann, Huber, Hübner, Candinas, Demartines, Weber and Beldi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Timm-Holzer, Eliane
Tschan, Franziska
Keller, Sandra
Semmer, Norbert K.
Zimmermann, Jasmin
Huber, Simon A.
Hübner, Martin
Candinas, Daniel
Demartines, Nicolas
Weber, Markus
Beldi, Guido
No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
title No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
title_full No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
title_fullStr No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
title_full_unstemmed No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
title_short No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
title_sort no signs of check-list fatigue – introducing the stop? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338924/
https://www.ncbi.nlm.nih.gov/pubmed/37457099
http://dx.doi.org/10.3389/fpsyg.2023.1195024
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