Background

Suboptimal communication can lead to preventable preoperative delays. In our study, we aimed to identify factors delaying surgery in the immediate preoperative period. Our outcomes of interest were the anesthesia release to incision time (RIT) and preoperative expectations of neurosurgery and anesthesia providers. Additionally, we introduced new communication goals prior to induction, to examine the impact on preoperative efficiency.

Methods

The study is a prospective cohort analysis evaluating communication in the immediate preoperative period. In 42 consecutive cranial neurosurgical cases, a questionnaire was given to neurosurgical and anesthesia providers, and their responses were recorded. Halfway through this study, a formal pre-induction checklist was implemented that included expected duration of surgery, expected blood loss, surgical positioning, and intraoperative medication requirements.

Results

Comparing the cohorts before and after implementing the checklist, no difference in release to incision time was observed. However, the difference in estimated procedure time was significantly decreased after implementation of the formal pre-induction checklist. Further, there was a trend towards better agreement in estimated blood loss, although results did not achieve statistical significance. These delays all demonstrated a statistically significant decrease after the new communication goals were executed.

Conclusion

While no statistically significant change in release to incision time was uncovered during our study, there was evidence that communication between teams improved after implementation of the checklist. Additionally, we observed less discrepancy in estimated case length and blood loss, suggesting focused communication goals aligned expectations of the neurosurgical and anesthesia teams.

中文翻译：

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神经外科医师和麻醉师之间的交流会提高术前效率吗？

背景

沟通欠佳会导致可预防的术前延误。在我们的研究中，我们旨在确定术前立即延迟手术的因素。我们感兴趣的结果是麻醉释放至切口时间（RIT）以及对神经外科手术和麻醉提供者的术前期望。此外，我们在上岗之前引入了新的沟通目标，以检查对术前效率的影响。

方法

该研究是一项前瞻性队列分析，评估术前即刻的沟通。在42例连续的颅神经外科病例中，向神经外科和麻醉提供者提供了一份问卷，并记录了他们的反应。在这项研究的一半，实施了正式的诱导前检查清单，其中包括预期的手术时间，预期的失血量，手术位置和术中用药需求。

结果

比较实施检查表前后的队列，未观察到切口释放时间的差异。但是，实施正式的入职前检查清单后，估计手术时间的差异显着减少。此外，尽管结果没有达到统计学上的显着性，但估计失血量仍趋于一致。在执行新的沟通目标后，所有这些延迟均显示出统计学上的显着下降。

结论

尽管在我们的研究中没有发现释放切口的时间有统计学上的显着变化，但有证据表明，在实施清单后团队之间的沟通得到了改善。此外，我们观察到病例数和失血量的估计差异较小，这表明重点沟通的目标与神经外科和麻醉小组的期望保持一致。