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Theatre staff briefings welcomed by nurses but questioned by management

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An airline pilot who has been helping train NHS theatre staff to improve safety and efficiency has criticised hospital managers for failing to back a new initiative.


Guy Hirst, a former British Airways pilot with more than 30 years’ experience, has been training theatre nurses, surgeons, and anaesthetists in teamwork skills as part of the NHS Institute for Innovation and Improvement’s new Productive Operating Theatre programme.

The programme involves a five-minute briefing at the beginning of each working day, during which staff introduce themselves and ensure they have access to all necessary equipment. It is intended to improve both safety and efficiency.

The Productive Operating Theatre programme was initially piloted at the Royal Devon and Exeter NHS Foundation Trust, Heart of England Foundation Trust in Birmingham and West Middlesex University Hospital NHS Trust.

Further trials took place at Medway NHS Foundation Trust, Rotherham NHS Foundation Trust and Central Manchester University Hospitals NHS Foundation Trust. The scheme is set to launch nationally in September.

But Mr Hirst claimed that management had not been supportive of the briefing session in some pilot sites and appeared to view it as a waste of time.

‘The layers of management who are running operating theatres need to understand the importance of this short time needed for a briefing. It takes five minutes,’ he told Nursing Times. ‘We think it is great, the nurses think it is great – but the management think it is a waste of time.’

Mr Hirst said that anecdotal evidence from the pilot sites suggested that the briefings were saving anything up to 20% of overall theatre time ‘by identifying problems earlier in the day’.

Claire Bradford, a theatre matron at Royal Devon and Exeter trust, backed the briefings. ‘Everybody knew their role, everybody knew what was expected. It is preparing the whole team for the whole day for what we have on the list,’ she said.

The Productive Operating Theatre programme follows the launch of the World Health Organization’s Safe Surgery Saves Lives checklist in June 2008, which includes a ‘time out’ immediately before incision in order to confirm the patient’s identity and the procedure to be performed.

Both initiatives have borrowed from the airline industry where the safety check concept is well-established. ‘Training in this [safety checks] has become mandatory in the airline industry, everybody does three days’ training on this issue every year – that is how important it is,’ said Mr Hirst.

The National Patient Safety Agency, which has adapted the WHO checklist for use in the NHS, has told acute trusts in England and Wales that they must begin using it before February 2010.

A Nursing Times investigation in February this year revealed only one-quarter of acute trusts had introduced the checklist.

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