ABSTRACT
This chapter describes how the data from the study were used to develop and implement a multi-institutional programme to improve surgical teamwork. Observers of the surgical procedures were all registered nurses. Procedures were selected for observation on the morning of the surgery based on consent of all team members to be observed, compatibility with the operational needs of the surgical suite, anticipated length of the procedure and availability of the observer. The surgical procedures were classified as low, medium or high risk for post-operative complications according to American College of Cardiology and American Heart Association guidelines. The gender and race/ethnicity distribution were generally representative of Kaiser Permanente members undergoing general surgery procedures at the participating hospitals. The Surgical Care Improvement Project safety checks were added to the briefing checklist to enhance reliable protection from infection, Venous Thromboembolism and Miocardial Infarction.
