Briefings: what can surgical and minimally invasive interventional teams learn from airline flight deck practice?

Abstract

While healthcare should not be compared to aviation or indeed other high reliability organisations (HROs), many lessons, attitudes, and transferable practices can be applied and, more importantly, adapted from them to improve patient safety and team morale. The team brief before any interventional list is one such process that can have a significant effect on the delivery and safety of patient care and effective team working. Due to NHS pressures and the perception by some in healthcare that the time taken to conduct a full team briefing has little importance, it can sometimes be rushed or regarded as a 'tick box' process that delays a list. However, when used appropriately, the briefing is a chance to lower authority gradients and thereby improve patient safety. It also reduces the likelihood of medical errors, builds and improves situational awareness by considering various 'what-if' scenarios and how they will be dealt with, and considers wider issues including potential distractions. An important outcome is its effect on team morale through empowerment, and it is an opportunity for learning. In this article, which has been written following a unique opportunity to observe a full team brief on an Airbus A380 flight deck, we consider how, through the thorough use of checklists, briefings can be used to best advantage for interventional teams. We raise the question 'would you engage differently with the briefing if your own life or procedure depended on it?'

Keywords: Human factors; Morale; Patient safety; Team brief; Teamwork.