Identifying methods to improve heart surgery: an operative approach and strategy for implementation on an organizational level

ElBardissi, Andrew W.; Wiegmann, Douglas A.; Henrickson, Sarah E.; Wadhera, Rishi K.; Sundt, Thoralf M.

doi:10.1016/j.ejcts.2008.07.007

Cited by 78 publications

(77 citation statements)

References 20 publications

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“…Of these studies, one used the Safety Attitude Questionnaire (SAQ), 23 one used a rating system for teamwork behaviour, 51 and one study focused on events disrupting teamwork. 36 Of the five studies investigating leadership processes, four conducted observations but used different observation systems 31 42 43 52 and one study used a survey. 24 Of the four studies focusing on coordination, three 39 -41 used the coding system of Manser and colleagues 53 and one assessed coordination using a survey.…”

Section: Team Processes Investigated and Their Measurementmentioning

confidence: 99%

Do Team Processes Really Have an Effect on Clinical Performance? A Systematic Literature Review

Schmutz

Manser

2013

Survey of Anesthesiology

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Editor's key points † This review has examined the impact of team process behaviours on clinical performance. † Twenty-eight studies, which reported at least one relationship between team process or an intervention and outcome, were reviewed. † Team process behaviours have been shown to influence performance. † Training in team behaviours results in improved performance.Summary. There is a growing literature on the relationship between team processes and clinical performance. The purpose of this review is to summarize these articles and examine the impact of team process behaviours on clinical performance. We conducted a literature search in five major databases. Inclusion criteria were: English peer-reviewed papers published between January 2001 and May 2012, which showed or tried to show (i) a statistical relationship of a team process variable and clinical performance or (ii) an improvement of a performance variable through a team process intervention. Study quality was assessed using predefined quality indicators. For every study, we calculated the relevant effect sizes. We included 28 studies in the review, seven of which were intervention studies. Every study reported at least one significant relationship between team processes or an intervention and performance. Also, some non-significant effects were reported. Most of the reported effect sizes were large or medium. The study quality ranged from medium to high. The studies are highly diverse regarding the specific team process behaviours investigated and also regarding the methods used. However, they suggest that team process behaviours do influence clinical performance and that training results in increased performance. Future research should rely on existing theoretical frameworks, valid, and reliable methods to assess processes such as teamwork or coordination and focus on the development of adequate tools to assess process performance, linking them with outcomes in the clinical setting.

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Section: Team Processes Investigated and Their Measurementmentioning

confidence: 99%

Do Team Processes Really Have an Effect on Clinical Performance? A Systematic Literature Review

Schmutz

Manser

2013

Survey of Anesthesiology

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“…This study [36] and others [41] found that teamwork was critically important to the capture and compensation of errors, a finding which may not be intuitive to those without formal training. Thus, once stable teams, standardized communication methods, and effective briefings have been developed, a process of formal training and education in human factors and human error should be instituted.…”

Section: The Cycle Of Human Factorsmentioning

confidence: 98%

“…Such a performance can be optimized by selecting operators who possess the best profile of characteristics for the job. Recently in the literature strategies to improve surgical practice have been proposed, including a preoperative briefing, restructuring of the method of staffing surgical teams, standardized intraoperative communication, and a postoperative debriefing [36] .…”

Section: The Cycle Of Human Factorsmentioning

confidence: 99%

“…Thus, once stable teams, standardized communication methods, and effective briefings have been developed, a process of formal training and education in human factors and human error should be instituted. If surgical teams are carefully selected, this training and process change will provide teams with the knowledge and environment that will facilitate the breakdown of the hierarchical structure that currently impedes the development of effective patient safety programs [36] .…”

Section: The Cycle Of Human Factorsmentioning

confidence: 99%

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Human Factors in Surgery: From Three Mile Island to the Operating Room

et al. 2009

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Human factors is a definition that includes the science of understanding the properties of human capability, the application of this understanding to the design and development of systems and services, the art of ensuring their successful applications to a program. The field of human factors traces its origins to the Second World War, but Three Mile Island has been the best example of how groups of people react and make decisions under stress: this nuclear accident was exacerbated by wrong decisions made because the operators were overwhelmed with irrelevant, misleading or incorrect information. Errors and their nature are the same in all human activities. The predisposition for error is so intrinsic to human nature that scientifically it is best considered as inherently biologic. The causes of error in medical care may not be easily generalized. Surgery differs in important ways: most errors occur in the operating room and are technical in nature. Commonly, surgical error has been thought of as the consequence of lack of skill or ability, and is the result of thoughtless actions. Moreover the ‘operating theatre’ has a unique set of team dynamics: professionals from multipledisciplines are required to work in a closely coordinated fashion. This complex environment provides multiple opportunities for unclear communication, clashing motivations, errors arising not from technical incompetence but from poor interpersonal skills. Surgeons have to work closely with human factors specialists in future studies. By improving processes already in place in many operating rooms, safety will be enhanced and quality increased.

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“…This paper by ElBardissi and colleagues [1] applies the human factor analysis techniques to cardiac surgery. In the study, a trained observer watched 31 operations and noted disruptions to the smooth flow of the operation as technical errors and teamwork failures.…”

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confidence: 98%

Editorial comment

Nashef

2008

European Journal of Cardio-Thoracic Surgery

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Identifying methods to improve heart surgery: an operative approach and strategy for implementation on an organizational level

Cited by 78 publications

References 20 publications

Do Team Processes Really Have an Effect on Clinical Performance? A Systematic Literature Review

Do Team Processes Really Have an Effect on Clinical Performance? A Systematic Literature Review

Human Factors in Surgery: From Three Mile Island to the Operating Room

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