Eyes on incivility in surgical teams: Teamwork, well-being, and an intervention

Abstract

Incivility in surgery is prevalent and negatively impacts effectiveness and staff well-being. The purpose of this study was to a) examine relationships between incivility, team dynamics, and well-being outcomes, and b) explore a low-cost intervention of ‘eye’ signage in operating theater areas to reduce incivility in surgical teams. A mixed methods design was used in an orthopedic hospital. Surveys of incivility, teamwork, and well-being were administered three months apart in a small private hospital. An intervention of signage with eyes was placed in the theater area after administration of the first survey, using a pretest-posttest design. Participants also responded to an open-ended question about suggestions for improvements at the end of the survey which was then thematically analyzed. At the individual level (n = 74), incivility was statistically significantly related to team dynamics which in turn was significantly related to burnout, stress, and job attitudes. At the aggregate level, reported incivility was statistically significantly lower after the ‘eye’ sign intervention. Thematic analysis identified core issues of management behaviors, employee appreciation, communication, and work practices. Incivility in surgical teams has significant detrimental associations with burnout, stress, and job attitudes, which occurs through its impact on decreased team dynamics and communication. A simple intervention that evokes perceptions of being observed, such as signage of eyes in theater areas, has the potential to decrease incivility at least in the short term, demonstrating that incivility is amenable to being modified. Additional research on targeted interventions to address incivility are needed to improve teamwork and staff well-being.

From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes

“…Moreover, uncivil behaviors can strain nurse-patient interactions, potentially diminishing the quality of care and patient satisfaction [ 18 , 37 ]. At an organizational level, incivility can disrupt team dynamics, contribute to higher staff turnover rates, and negatively influence the overall culture within healthcare institutions [ 18 , 38 , 39 ]. Furthermore, the economic implications of nursing incivility, such as costs associated with staff replacement and lost productivity due to absenteeism and presenteeism, warrant further investigation [ 40 – 42 ].…”