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Information transfer in multidisciplinary operating room teams: a simulation-based observational study
  1. David Cumin1,
  2. Carmen Skilton2,
  3. Jennifer Weller2,3
  1. 1Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
  2. 2Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
  3. 3Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Dr David Cumin, Department of Anaesthesiology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; d.cumin{at}auckland.ac.nz

Abstract

Background Communication of clinically relevant information between members of the operating room (OR) team is critical for safe patient care. Formal communication processes, such as briefing, sign in and time out, are designed to promote this.

Aims We investigated patterns of communication of clinically relevant information between OR staff in simulated surgical scenarios, to identify factors associated with effective information sharing. We focused on the influence of precase briefing, sign in and time out, which we defined as formal team communications.

Method Twenty teams of six participated in two scenarios during a day-long course. Participants each received unique, clinically relevant items of information (information probes) prior to simulations and were tested postscenario on recall of the information in the probe. Using videos of the simulations, we coded each time an information probe was mentioned against a structured framework.

Results Of the 145 instances where a probe was mentioned at least once, 75 (51.7%) were mentioned during a formal team communication. However, there were 89 instances of a possible 234 (38%) where a probe was never mentioned. Some team members were more likely to mention the information than others. When probes were mentioned during formal team communications, significantly more team members were attentive (1.4 vs 2.3; p<0.001), the information was significantly more likely to be recalled and the team was five times more likely (p=0.01) to recall the information than if the information was only mentioned outside of a formal communication.

Conclusions While our study supports the value of formal team communications during precase briefing, sign in and time out in the Surgical Safety Checklist, our findings suggest suboptimal transmission of information between team members and unequal contributions of information by different professional groups.

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Footnotes

  • Contributors All listed authors have contributed to the design of the study, data collection, data analysis and interpretation, and drafting and critically revising the content of the manuscript. All authors have approved the final version of the manuscript.

  • Funding The majority of funding came from a Health Workforce New Zealand Innovations Grant. Additional funding for research was provided by the Auckland Medical Research Foundation, the University of Auckland School of Medicine Foundation and the Joint Anaesthesia Foundation Auckland. Donations of consumable items from Kimberly-Clark, Smith & Nephew, NZ Blood, Covidien and Baxter, and equipment loans from the Definitive Surgical Trauma Care Course (NZ), OBEX and Zimmer made it affordable to construct a realistic environment and allowed us to offer it at no cost to participants.

  • Competing interests None declared.

  • Ethics approval We obtained approval from the Central Regional Ethics Committee, CEN/12/03/002.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Original data are available on request to the corresponding author.

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