Context It is widely believed that the emotional climate of surgical team's work may affect patient outcome.

Objective To analyse the relationship between the emotional climate of work and indices of threat to patient outcome.

Design Interventional study.

Setting Operating rooms in a high-volume thoracic surgery centre from September 2007 to June 2008.

Participants Thoracic surgery operating room teams.

Intervention Two 90 min team-skills training sessions focused on findings from a standardised safety-culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication and leadership.

Main Outcome Measures Relationship of functional or less functional emotional climates of work to indices of threat to patient outcome.

Results A less functional emotional climate corresponded to more threat to outcome in the sterile surgical environment in the pre-intervention period (p<0.05), but not in the post-intervention or sustaining period of this study. This relationship did not exist in the anaesthesia or circulating environments of the operating room.

Conclusions The emotional climate of work in the sterile surgical environment appeared to be related to threat to patient outcome prior to, but not after, a team-training intervention. Further study of the relationship between the emotional climate of work and threat to patient outcome using reproducible methods is required.