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Safer Surgery part 20. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 164 Safer Surgery What were the remarks incidents mentioned during the debriefing Several remarks and incidents were reported the most reported ones are described below subdivided into the categories used in the questionnaire. Communication and teamwork n 44 - Improving communication between all team members improving information on patient characteristics surgical day schedule necessary equipment and surgical approach 32 per cent of the remarks communication teamwork . - Improve team spirit and teambuilding 20 per cent . - Show respect for your all OT-members and be honest 11 per cent . Situational awareness n 30 - Improving information on the surgical day schedule better preparation of surgery including instrument set-up improve written communication introduce pre-operative team meeting 33 per cent . - Update on status of surgery 7 per cent . - Implement standards and protocols including communicating this to all team members 7 per cent . Decision-making n 1 - Improvements should be implemented faster. - Leadership total 5 remarks . - Less hierarchy more commitment increase consultation and direct communication 60 per cent . Discussion The results of the pilot provide important information for implementing TOPplus on a wider scale and ensure that it supports its objectives. Some elements of the poster are still subject to discussion. The main conclusions are presented below. In general four topics for discussion were reported 1. The moment of the time out just before incision rather than before administering total or local anaesthesia. 2. Performing a debriefing with patients under local anaesthetic. 3. Performing a time out and debriefing when three or more similar and relatively simple surgical procedures are scheduled successively. 4. The content of the time out being context specific as expected . The recently published Surgical Safety Checklist of the WHO World Health Organization 2008 p. 153 splits the checking process in three parts Before induction of .
