In surgery, as much as 30% of procedure-specific information may be lost as a result of miscommunication. We assessed the relationship between interruptions, team familiarity, and miscommunications across a purposive sample of 160 surgical procedures in 10 specialties during a six-month period. Descriptive analysis was used to quantify interruptions in respect to the source (ie, conversational, procedural) and type of miscommunication (ie, audience, purpose, occasion, content, experience). Results revealed an inverse correlation between the length of time that teams had worked together and the number of miscommunications in surgery (τ = -.33, P < .01). There was a positive correlation between the number of intraoperative interruptions and the number of miscommunications (τ = .30, P < .01). These results may help to inform the development of evidence-based interventions designed to mitigate the effects of miscommunications in surgery.
As a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: "building shared understandings through open communication"; "managing contextual stressors in a hierarchical environment" and "intermittent membership influences team performance". In creating a safety culture in a healthcare organisation, a team's optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.
Notwithstanding the lack of randomized controlled trials, synthesis of the existing body of evidence suggests a relationship between checklist use in surgery and fewer postoperative complications.
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