Teamwork and Communication in the Operating Room: Relationship to Discrete Outcomes and Research Challenges
Section snippets
Methods
A literature search was performed using the National Library of Medicine catalog and the following 3 search strategies, (((((Teamwork) OR Communication) OR Behavior) AND Surgery) AND Operating Room) AND (Outcome OR Error), (((Teamwork) AND Communication) AND Operating Room), and (((Teamwork) AND Communication) AND Surgery).
In total, 246 articles were returned. Criteria for inclusion in this study were that the article (1) addressed teamwork and/or communication in the operating room and (2)
Clinical Outcomes
Outcome measures used to assess the effect of measured teamwork and communication in the operating room include morbidity, mortality, technical errors, operating time and delays, and communication failures (Table 1). These outcomes have been measured directly or by proxy. In addition, some studies report risk factors for poor outcomes related to teamwork and communication. Various definitions and measurements of teamwork and communication themselves have been used in these studies.
Implications of Research on Teamwork and Communication in Relationship to Perioperative Outcomes
There is growing consensus that teamwork and communication failures contribute to perioperative adverse events; however, there are few data supporting this assertion. The authors could find only 3 studies attempting to identify a relationship between measures of teamwork and communication and perioperative morbidity and mortality.1, 2, 3 Only one of these studies identified a significantly increased risk of death in the setting of infrequent information sharing.2 The remaining studies that were
Summary
There is a small but growing body of literature demonstrating a relationship between teamwork and communication in the perioperative environment and discrete, measurable, clinically relevant outcomes. Future work in this field should seek to identify which elements of teamwork and communication are most important to improving and/or sustaining good outcomes and preventing the poor ones. Where possible, researchers should seek to use reproducible methods and use standardized data collection
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Cited by (44)
Operating room team training using simulation: Hope or hype?
2021, American Journal of SurgeryCitation Excerpt :The American Society of Anesthesiologists (ASA), American College of Surgeons (ACS), US Institute of Medicine, the Risk Management Foundation of the Harvard Medical Institutions (RMF), and malpractice insurers such as the Consolidated Risk Insurance Company (CRICO), the malpractice insurer for the Harvard Affiliated Hospitals, have cited teamwork dysfunction and breakdowns in communication among operating room (OR) team members as significant causes of preventable adverse events such as operative delays and technical errors.1,2 Furthermore, teamwork dysfunction is associated with decreased clinical performance and increased patient morbidity and mortality rates.3–7 In 2006, Lord Ara Darzi at the Imperial College in London created a scenario using a model of a bleeding femoral vessel during which a standard OR team was assessed for both technical and non-technical skills (NTS).8
Learning non-technical skills in surgery
2020, Journal of Visceral SurgeryCitation Excerpt :In the NOTSS system, the decision-making section highlights the identification of different options, making them known and executing them. Communication is the cornerstone of teamwork [31]. Several studies have shown that communication failures are at the origin of serious medical events [4,32].
Educating Perioperative Nurses About Local Anesthetic Systemic Toxicity Using High-Fidelity Simulation
2020, Pain Management NursingCitation Excerpt :However, the benefit of participating in simulation likely outweighs the inconvenience. Changes to patient safety outcomes as a result of educational experiences, simulation, and team communication exercises are very difficult to assess, and research is limited, but suggestive of the fact that poor communication between teams worsens patient outcomes (Nurok, Sundt, & Frankel, 2011). Conversely, participation in interprofessional simulation does improve perceived teamwork, climate, and safety, and these exercises may improve patient outcomes (Hinde, Gale, Anderson, Roberts, & Sice, 2016; Riley, Davis, Miller, Hansen, Sainfort, & Sweet, 2011).
Perianesthesia Nurses Are My Second Family: A Qualitative Descriptive Study
2017, Journal of Perianesthesia NursingCitation Excerpt :No research was found that explored nurses' perceptions of teamwork in the perianesthesia setting, except in literature that was conducted by or in combination with other professional groups, such as surgeons or anesthesiologists. Research has demonstrated both weak and strong associations between poor perianesthesia teamwork and patient outcomes.19,20 Irrelevant conversations have been found to be associated with poor team performance in operating rooms.21
In Situ Operating Room–Based Simulation: A Review
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Disclosures: Allan Frankel is a Principal at Pascal Metrics, a software analytics and consulting group aimed at data-driven interventions to improve patient safety and risk management.