• There's a safety issue — stop!
When nurses tell me they're concerned during a case, I immediately
stop to acknowledge those concerns. But that's not all. As you can see in
the sidebar to the right, your OR team should conduct safety sessions
before and after surgery as well.
OSM
Dr. Burney (dwightburney119@gmail.com) is an orthopedic surgeon in
Albuquerque, N.M., and active in the American Association of Orthopaedic
Surgeons' patient safety efforts.
J A N U A R Y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 5 3
went right and what could have gone better. Before you touch on
what could have gone better, start by discussing what went well
to get everyone comfortable with sharing their opinions. It's diffi-
cult for members of the team to criticize themselves, so the sur-
geon needs to step into a leadership role by showing some vul-
nerability with comments like, I should have told you about the
possibility of needing that equipment. Finally, discuss what the
team can do better during future cases and touch on specific
issues or concerns that you need to resolve before the next case,
such as replacing broken instruments. Debriefings lose their
effectiveness without a system in place that will address and cor-
rect issues that surgeons and staff identify. Who's accountable
for making that happen? Who will report back to the surgical
team when the problem is resolved? Those elements have to be
in place to ensure debriefings don't become pointless, time-
wasting exercises. — Dwight Burney, MD