Perceived barriers and facilitators on the performance of
perioperative briefing and debriefing
In total, the interviewees brought up 25 barriers and facilitators: 14
barriers and 10 facilitators, of which one was also a barrier (Table 3).
Most barriers were related to debriefing (n = 10), and most facilitators
were related to briefing (n = 6). We divided the barriers and
facilitators into four categories: innovation, professional, social
context and organisational context.
The barriers were mainly categorised into organisational (n = 6) and
social context (n = 3). The prominent organisational barriers were: lack
of dedicated teams, incomplete team, no follow-up of learning goals and
lack of control of improvement actions. Barriers to briefing were
related to innovation (n = 3), e.g. irrelevant questions and lack of
personal interest. The often mentioned professional-related barriers to
debriefing were: absence of a safe culture for (negative) feedback, lack
of culture of accountability and lack of priority by healthcare
professionals.
Facilitators were related to all categories. The important facilitators
for briefing were: the feeling that discussing the surgical programme,
including potential difficult situations, at the beginning of the day
fosters efficiency and helps maintain a good work flow. The important
facilitators for debriefing were the opportunity to give positive
feedback and to discuss complications or concerns regarding surgery.
Insert Table 3 Perceived barriers and facilitators by the interviewees
here -
Despite all the barriers, all interviewees acknowledged the added value
of both briefing and debriefing and their positive influence on team
climate. None of the interviewees suggested that either briefing or
debriefing should be abolished. All interviewees provided suggestions
for improvement (Table 4). Four were related to debriefing only, three
to briefing only and three to both briefing and debriefing. Most of the
suggestions (6/14) were related to innovation (e.g. timing and place,
asking more specific and relevant questions), two were related to
organisational factors (e.g. creating a reward system) and three to
social context (e.g. more attention to role models and constructive
feedback).
According to the interviewees, giving constructive feedback is
beneficial for team climate and professional learning. However, they
also acknowledged that they would rather not provide such feedback
during debriefing with the whole team, despite the fact that this is a
key element of debriefing. They would either ignore it or try to discuss
it face-to-face. Anaesthesiologists and surgeons should act as role
models when giving feedback within teams. The interviewees were unable
to present solutions for creating a safer culture for providing
feedback.
Insert Table 4 Suggested improvements for perioperative briefings and
debriefing by the interviewees here -