15. Pre operative Teaching Minimally invasive surgery instructions General outline of pre-op questions Procedure specific consent checklists Reliable internet sources
16. Let’s pretend you are the patient and you are at the doctor’s office… You do not know about your condition, You don’t know how to read…and the receptionist put you in the “special room, where the diplomas are, the golf pictures and the “I love my accomplishments” wall.
26. Pre-operative Teaching: Setting the Patient up for Success Provide minimally invasive surgery instructions Provide general outline of pre-op questions Inform the patient regarding: procedure specific consent checklists Verification checklists and/or pre-procedure checklists Provide Reliable internet sources
27.
28. To assess what the patient knows first before tackling the questions they may ask
29. To ask open ended questions to solicit information
30. Top Ten Questions How long will the surgery take? How long will I be in the hospital? What can’t I do when I get home? What will I need help with when I get home? Will I be on a special diet?
56. Pre-operative Briefing Key element is two way communication Clarify any questions the team might have about the procedure or the equipment Checklists on grease-boards are utilized in the pre-op area to insure that the whole team is on the same page
61. There is nothing so annoying as to have two people talking when you’re busy interrupting. Mark Twain
62. Debriefing Closing Counts? Labeling of specimens? EBL? Any equipment problems? What went well? What could we do different next time?
63. Team: A group of people with a full set of complementary skills that work together interdependently & cooperatively to complete a task.
64. Key markers associated with superior team performance: Leadership Assertive Communication Situational Awareness
65. Leadership Accept risk and responsibility Seek the collective wisdom of the team Create an atmosphere conducive to assertive communication Remember the leader of the team is a part of the team
66. Assertive Communication …an obligation, not just a right …must be timely …must not be criticized or ridiculed …is critical to patient safety in the OR
67. Situational Awareness Understanding what is happening in the surrounding environment and why Monitoring the current situation and accurately predicting what is likely to happen next to help the team prepare for the anticipated outcome
70. Nurse vs Physician perception Nurses describe good collaboration as having their input respected Physicians describe good collaboration as having nurses that anticipated their needs and followed direction
71. Who’s on your team? Strong leadership, assertive communication and situational awareness bridge the gaps between team members and are essential for safety in the OR as well as in the cockpit
72. Bibliography American College of Surgeons, Committee on Development of High Performance Teamwork in Surgery through Education. Statement on high-performance teams. Bulletin of the American College of Surgeons 2010; 95:23-24. Haynes AB, Weiser TG, Berry WR, et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. N Engl J Med 360:491, Jan 29, 2009. Makary MA, Sexton JB, Freischlag JA, et al. Operating Room Teamwork among Physicians and Nurses: Teamwork in the Eye of the Beholder. J Am Coll Surg 2006; 202: 746-752. Stokowski LA. Perioperative Nurses: Dedicated to a Safe Operating Room. Available at www.medscape.com/viewarticle/562998 Accessed February 15, 2010