Paper
Bridging the communication gap in the operating room with medical team training

Presented at the 29th Annual Surgical Symposium of the Association of VA Surgeons, Salt Lake City, Utah, March 11–13, 2005
https://doi.org/10.1016/j.amjsurg.2005.07.018Get rights and content

Abstract

Background

In the operating room (OR), poor communication among the surgeons, anesthesiologists, and nurses may lead to adverse events that can compromise patient safety. A survey performed at our institution showed low communication ratings from surgeons, anesthesiologists, and OR nursing staff. Our objective was to determine if communication in the operating room could be improved through medical team training (MTT).

Methods

A dedicated training session (didactic instruction, interactive participation, role-play, training films, and clinical vignettes) was offered to the entire surgical service using crew resource management principles. Attendees also were instructed in the principles of change management. A change team was formed to drive the implementation of the principles reviewed through a preoperative briefing conducted among the surgeon, anesthesiologist, and OR nurse. A validated Likert scale survey with questions specific to effective communication was administered to the nurses, anesthesiologists, and surgeons 2 months after the MTT to determine the impact on communication. Data are presented as mean ± SEM.

Results

There was a significant increase in the anesthesiologist and surgeon communication composite score after medical team training (anesthesia pre-MTT = 2.0 ± .3, anesthesia post-MTT = 4.5 ± .6, P <.0008; surgeons pre-MTT = 5.2 ± .2, surgeons post-MTT = 6.6±.3, P <.0004; nurses pre-MTT = 4.3 ± .3, nurses post-MTT = 4.2 ± .4, P = .7).

Conclusions

Medical team training using crew resource management principles can improve communication in the OR, ensuring a safer environment that leads to decreased adverse events.

Section snippets

Methods

To determine the baseline communication among nurses, surgeons, and anesthesiologists, a validated Likert scale survey with questions aimed at communication in the OR was administered. This was followed by a dedicated training session that was offered to the entire surgical service by the Veteran’s Affairs (VA) National Center for Patient Safety using crew resource management principles. This course consisted of didactic instruction, interactive participation, role-play, training films, and

Results

After the implementation of team training, the number of briefings performed was reviewed during 3 separate time periods. Fig. 1 shows an increase in the number of preoperative briefings from 64% at 1 month after implementation increasing to 100% by 4 months after implementation. To determine the impact of briefings on perceived communication among surgeons, anesthesiologists, and OR nurses, the results of the communication survey were examined at baseline and at 4 months after implementation

Comments

Poor communication among health care providers can result in potentially avoidable catastrophic medical errors. An increase in the publication of both retrospective and prospective studies has helped to shed more light on the challenging problem of medical errors. Data from the root-cause analysis database from the VA National Center for Patient Safety identified that 82% of root-cause analyses cited communication failure as at least one of the contributing/causal factors in an adverse event or

References (16)

There are more references available in the full text version of this article.

Cited by (293)

  • The scope and prevalence of perioperative harm

    2023, Handbook of Perioperative and Procedural Patient Safety
View all citing articles on Scopus
View full text