Team Debriefings in the OR

Briefings occur before or at the outset of a project, shift, procedure or event. Debriefings are no less valuable, and take place after completion of a shift or procedure. Debriefings are a "practical tool" that provides an institutionalized, standardized, and structured platform for "performance feedback" and individual, team, and organizational learning by allowing staff to discuss and question what challenges were faced, what went well, what did not go well, and what might be done better the next time.

The debriefing is the bookend to the briefing. It closes the loop on the expectations and climate set during the initial gathering by the team.

Debriefings, like briefings, should be concise and structured around a formalized model. The debriefing process should occur at the end of a shift, the end of a procedure, the end of a day, etc., while the events are still fresh in the minds of the participants.

Best Practices for Debriefings in the OR

One of the most common debriefing techniques in use in clinical and non-clinical settings is the three questions model:
  1. What went well?
  2. What did not go well and why?
  3. How can we improve for next time?

In addition, hospitals have included process improvement actions and built-in accountability procedures to ensure that opportunities for improvement that are identified are acted upon and implemented. The debriefing helps close the loop on the Crew Resource Management skills that are put into practice during a case, procedure, operation, task or project.

Like medical briefings and other Crew Resource Management skills, medical debriefings take practice. However, it is easy to start. Like other Crew Resource Management skills, debriefings in the OR can be implemented quickly and easily. But to affect change and contribute to an overall culture of patient safety, the skill and methodology of debriefings in the OR should be standardizedwith a common process and policy. The medical debriefing process should be rolled-out organization-wide beginning with staff training and reinforced with direct observation and coaching.

Debriefing in the OR Behaviors

The medical Debrief provides an opportunity to evaluate and recognize teams or individuals for their performance. This includes identifying areas where performance needs improvement. It is a feedback session. Teams should strive to make the following behaviors part of your routine debriefing process:
  • Conduct self-critique.
  • Accept/encourage feedback and suggestions.
  • Focus on process.
  • Demonstrate consistency.
  • Conduct Self Critique

Openly critique your actions in the OR and determine what you can learn from them. Encourage similar behavior on the part of other team members. This should be approached as an opportunity to learn from recent experience. Unless you are aware of your performance, you cannot know what you should continue doing or what you should change.

Debriefings in the OR Should Encourage Feedback 

Be open to feedback and actively solicit it. Use body language that is unambiguous and friendly. Do not turn away from fellow team members when soliciting feedback.

Focus On OR Process

It is important that the healthcare team understands its effectiveness in the process. Doing things right is only half way to effective team coordination. Doing “the right thing right” is the ultimate goal. In describing process, address: what, why, how, when, where, as well as who. When evaluating individuals or teams, apply the principles of Effective Feedback.

Demonstrate Consistency

Make medical debriefs a routine part of the job. They are critical to continuous improvement and doing “the right thing right.” Make time for the OR debriefing process!

Contact Safer Healthcare 

We welcome your questions and inquiries about our programs, products and services. Contact Safer Healthcare's team of Crew Resource Management experts to learn how we can help your organization increase levels of patient safety and improve the quality of safe and reliable care while maximizing profitability.