Information
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Document No.
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Conducted on
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Prepared by
Hospital Theatre Setting
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Hosptial Wing
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Theatre Complex
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Which Theatre
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Which theatre?
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Which Lab?
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Theatre Complex
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Which theatre?
- Theatre 1
- Theatre 2
- Theatre 3
- Theatre 4
- Theatre 5
- Theatre 6
- Theatre 7
- Theatre 8
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Which theatre?
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Which theatre?
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Which theatre?
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Which Specialty is the operating list?
- Cardiac
- Thoracic
- Neurology
- Urology
- General
- Gynaecology
- Obstetrics
- Paediatrics
- Plastics
- Trauma
- Orthopaedic
- Spinal
- Neonatology
- Ears, Nose, Throat
- Maxillo Facial
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How would you describe this list
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Who is the named Consultant for this List/Case?
Briefing huddle
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What time did the Theatre Briefing begin?
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Where was the Theatre Briefing conducted? ie. anaesthetic room, corridor etc
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Is there a sign-posted protected area for the team briefing?
Please select the staff/personnel present at briefing
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Consultant Surgeon
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Surgical Registrar
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Consultant Anaesthetist
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Anaesthetic Registrar
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Anaesthetic Practitioner (ODP/Nurse)
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Surgical Scrub Lead Practitioner / Team Leader
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Health Care Assistant
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How many other scrub nurses and circulating staff are present
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Are there other personnel present?
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Role:
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Role
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Role:
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Add a photo of briefing, team and location
Theatre Briefing
Surgical Procedures on list
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1. Planned Surgical Procedure for all patients discussed?
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Please Comment
Order of Patients
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2. Order of the list confirmed/discussed
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What is the reason?
Patient Review
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3. Have all patients been seen by the anaesthetist?
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Please comment
Equipment Checks
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4. Has equipment (including prosthesis & monitoring) been discussed and available
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5. Have any issues been identified?
Post operative care
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6. Have any post-operative requirements or special investigations been raised for any of the patients?
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Please comment
Follow up and Closure
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7. A team member is given responsibility to follow up any issues raised
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8. A scribe is nominated to track QI issues during the list for follow up
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9. Team members asked to summarise cases and any anticipated issues to close briefing.