The Intratheater Latest Pre-Operative Discussion: Advocacy for Patient Safety, Procedural Optimization, and Surgical Education

Background In the operating theater, surgeons must harness preparatory tools for quality assurance and team convergence. This study aims to evaluate perceptions of the latest pre-operative discussion, a presentation showcasing patient information, literature discussion, and team dialogue held with the entire operative team. Methods A prospective, anonymous survey was distributed to all trainees who participated in the latest pre-operative discussion at the Chang Gung Memorial Hospital microsurgical reconstruction department between January 2016 - December 2022. Survey questions evaluated patient safety/decision-making, operative flow, and education of the latest pre-operative discussion. Secondary outcomes were gathered from review of all discussions held in 2022, including number of manuscripts reviewed and changes in operative plan following team deliberation. Results Of sixty fellows and residents, fifty respondants (60% fellows, 40% residents) completed the survey, with a 83% response rate. At least 90% strongly agreed or agreed with all positive statements; 94% stated they will/have implemented the practice. An average of 2.3 projects were initiated in response to each discussion. Fellows more often strongly agreed that the discussion helped critique the quality of literature (78% vs 46%; p = 0.028), find gaps in currently knowledge (88% vs 66%; p = 0.044), and generate research topics (90% vs 74%; p = 0.028). Of seventy-one discussions in 2022, an average of 5.1 manuscripts were reviewed in each presentation, and 10.7% of final plans were changed as a result. Conclusions Trainees widely reported benefit of the latest pre-operative discussion in patient safety, operative flow, and education, with disparity amongst training levels in educational value. Formalized discussion may benefit surgical team decision-making and review contemporary literature, while allowing all operative staff to perform in congruity.