Successful Team Briefings

The team briefing is a short, face-to-face gathering with you and your team to discuss important information and resolve issues before taking action. Team briefings begin the team learning cycle that includes team briefing, the performance of the activity, diagnosis of performance and team debriefing. It is a valuable step in the learning cycle as it helps everyone on the team stay focused on a situation at all times. 

Part of the family of communication skills of Crew Resource Management (CRM), the team briefing allows your team to anticipate errors and take responsibility for—and become more proactive toward—patient safety and quality of care.

All care providers are afforded the opportunity to communicate equally and openly with each other in the team briefing, regardless of an individual member’s status in the hierarchy.

Teams have a learning cycle. It begins with a briefing to clarify plans and set goals. Next, the team performs the activity and diagnoses the team’s performance. Finally, the team completes the learning cycle by debriefing, during which the team analyzes performance and provides feedback.

The team briefing is a short, face-to- face gathering with you and your team to discuss important information and re- solve issues before taking action. Y our leader—a team’s most senior member (often a physician or department super- visor)—routinely calls you and other members to a team briefing before a task, procedure or process, such as a shift change, patient transfer or staff rotation, begins. In addition to a team briefing, your leader can call the team together for a quick “huddle” whenever necessary to refocus or deal with an un- expected change. The huddle can follow the same communication procedures as the team briefing.

Team briefings are critical in the learning sequence because they enhance compre- hension. Studies show that learning is facilitated by, and may even depend on, dialogue and interaction with others. By looking at the team learning cycle (Team Learning Cycle Diagram, page 4), we can understand the process of learning that takes place. The team learning cycle illustrates the importance of teams pre- paring before they engage in task performance (i.e., briefing) as well as providing diagnostic feedback to one another after engaging in task performance (i.e., debriefing or post-action review).

Part of the family of communication skills of Crew Resource Management (CRM), the team briefing, helps everyone on the team stay focused on a situation at all times. Your team can anticipate errors and take responsibility for—and become more proactive toward—patient safety and quality of care. As you gather with your team to review necessary information, you will use the critical technique of team briefings to enhance patient safety.

Using effective communication skills— for example, attentiveness and active listening—empowers you to ask and answer questions from anyone on your team. These skills also empower you to speak up, while a task is underway, when something isn’t going as expected or a mistake is being made. All care provid- ers are afforded the opportunity to com- municate equally and openly, regardless of an individual member’s status in the hierarchy. Finally, using effective communication skills demonstrates your respect for all members of your team and results in everyone serving the best interest of the patient.

The team briefing also helps you gain situational awareness (SA) of the task from the beginning. SA is the constant state of knowing what’s going on in your immediate environment, why it is hap- pening and what is likely to happen next. Teams work together better and avoid unnecessary surprises, since everyone is communicating about what is supposed to occur and how to handle a situation when something goes wrong. You and your team get in sync with the flow of procedures by clarifying what you must do and how and when you must do it. It helps you see the big picture and stay “on the same page” as your team. The team briefing brings focus from the very beginning.

Learn these important characteristics of the team briefing:

• It is short and to the point, lasting no more than one to four minutes; this time limit is strictly observed.
• It occurs at a prescribed point in time before the task.
• All members must gather before the leader can begin.
• It consists of a structured, standardized series of dialogs between the members, following a series of steps as outlined on an approved checklist.
• During the team briefing, members deliver information in a clear and concise manner.

Improving Patient Safety

Team briefings improve patient safety. They alert you and your team to the avail- able resources, patient risk factors and any necessary record-keeping that might have been overlooked. You keep communicating during the task and alert each other in a timely fashion on complications and potential errors that may occur.

If the team briefing occurs before a procedure, the leader pauses for a short time-out. During this time-out, you and your team identify that you are working with the correct procedure, on the correct patient and any other relevant issues to ensure the procedure will be done cor- rectly and safely. This information is documented, and all members involved in the procedure must actively commu- nicate with each other. Members should use a key elements checklist that identi- fies all items that must be made available for the procedure. Your team must match the available items in the procedure area to the patient. As soon as the time-out procedures have been completed, the leader brings the team back to the regular flow of the team briefing.

Reducing medical errors is a direct result of team briefings. The leader’s advisory to keep an eye open for “red flags” ensures that error trapping and correction techniques occur during the task. With these techniques, members can become poised to anticipate an error before it occurs, or catch it if it occurs, then correct it in a timely manner so that it doesn’t affect the patient. In ad- dition, before the end of the task, team members double-check all procedures to mitigate any errors that may have not been caught. Open communication also leads to better error reporting, as the focus changes from “who is to blame” to “how can we all do better.”

Contingency Planning

Before a task, the team reviews contingency or backup plans that should be implemented if complications or other unexpected events occur during the task, or if procedures don’t have the anticipated result. Having contingency plans in place beforehand informs everyone on the team exactly how to act in such an emergency, without being surprised if it happens.

In contingency planning, members address the potential for an alternate or additional plan of action for the patient that includes setting a bottom line, assigning tasks or describing a backup plan. Contingency planning also re- quires that your team has immediate access to equipment, devices and other resources that you wouldn’t need under normal circumstances.