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How do I implement effective briefings that are used in the operating room on the nursing unit?

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Crew resource management (CRM)-based briefings can and should be used outside the operating room (OR) wherever healthcare professionals work together to deliver and manage patient care. This is especially true on medical-surgical nursing units where activity occurs at a fever pitch, patient acuity is high, and the need for effective communication remains constant 24/7.

When implemented appropriately, briefings can have a profound effect on the quality of communication and collaboration within healthcare teams; however, I have also seen the briefing concept misinterpreted and implemented improperly in practice. This ultimately yields communication that falls short of what is intended.

Let’s look at some key points about briefings and discuss application to the nursing environment. An effective briefing should be:

  • Short: Briefings are designed to be succinct. This is relative, of course. For example, a briefing by a nurse to a nursing assistant at the start of a shift, or a surgeon prior to making an incision, may be three to five minutes in length. A briefing by a nurse to a patient before starting an IV or a physician to a nurse in a cardiac step down area may be shorter. The exact time required to brief is not important. However, if you find yourself talking on and on, and five minutes becomes 15, then the briefing threshold has been crossed. The point is, keep it short.
  • Informative: Briefings should not be idle chat. They have a specific purpose, which is to convey important information. When briefing the team, you must have a clear idea of the salient and necessary points the team must know. Insignificant or superfluous information can create confusion and de-emphasize previously stated goals for the task at hand.
  • Structured: Briefings are not free verse and open-ended, with several people talking all at once about their point of interest. On the contrary, briefings are led by one person, usually the individual in charge, and follow a predetermined format. This makes sense. If there is a lot of information to be delivered in a short period of time, using a template or outline ensures that the briefer stays on track and the team remains focused. The best method for providing structure to a briefing is the use of an acronym, it is best to have it written down and carried for reference. When I was an airplane captain, I used a pocket-sized laminated checklist when conducting the preflight briefing with the flight attendants and first officer. This worked well because it enabled me to stay organized and consistent, especially when I was feeling rushed or pressured between flights.

Gary L. Sculli, RN, MSN, ATP

David M. Sine, MA, CSP, ARM, CPHRM

(April 2011)