Mad as a hatter? Evaluating doctors' recall of names in theatres and attitudes towards adopting #theatrecapchallenge

Abstract

Therefore, should a patient undergo elective 12 h surgery on the weekend, which, whilst negating the twilight period in our study, would potentially be associated with the worst outcomes in our cohort? Morton and Snow 1 caution against limiting the large number of operations admitted electively to intensive care out-of-officehours, because we can only measure 'those patients operated on'. It is our belief that this cohort does not reflect patients denied surgery solely based on the availability of in-office-hour surgical lists, nor do we believe that greater in-office-hour surgical completion would result in a zero-sum game (i.e. delaying elective surgery to in-office-hours will result in more adverse outcomes). 5 Our results suggest that using out-of-office-hour intensive-care facilities as a vehicle to reduce waiting lists for elective major surgery may not be the safest or most cost-effective means. There are certainly other options in reducing waiting lists for elective surgery, including expanding the number of operating theatres and the development of high dependency units. We hope that our findings stimulate further research and consideration, especially given that the timing and order of elective surgical lists, in conjunction with a patient's perioperative workup, are theoretically amenable to strategic health system planning. Whilst we believe the political, administrative, and workforce priorities will always mandate a need for out-ofoffice-hour elective procedures, the one-third of all planned cases requiring intensive care services are well above the 1e8% of planned surgical cases returning to ward-based care during out-of-office-hour periods. 6,7 We are grateful to Morton and Snow 1 for encouraging further debate in this important area of surgical, anaesthesia, and intensive care practice. Authors' contributions Morton & Snow wrote a letter to the BJA editors about our manuscript and we are responding. It will make sense when the letters are placed in order and the BJA provide a reference or doi for the Morton & Snow letter.

Improving teamwork and communication in the operating room by introducing the theatre cap challenge

“…Accordingly, the World Health Organization (WHO) Surgical Safety Checklist (SSC) briefing includes an introduction stating name and role of all team members before start of a procedure. However, there is little data to support how name and role introductions improve name recall amongst staff ( Birnbach et al 2017 , Burton et al 2018 ). Simple strategies to remember and use each other’s names and roles, besides the SSC introduction round, writing down the names on a whiteboard and team briefing exist.…”

Surgical caps displaying team members' names and roles improve effective communication in the operating room: a pilot study

“…One proposed solution to increase awareness of team members first names was to display staff members name and role on the front surface of their theatre hat. This idea had received significant attention in the media and to a limited degree in anaesthetic [ 16 , 17 ] and obstetric [ 18 ] literature. This idea had not been extensively tested despite having a high degree of face validity, and existing evidence was limited to specific craft groups or operation types.…”

You Have Control: aviation communication application for safety-critical times in surgery

“…Solutions include using a whiteboard with names and roles, or better, using printed theatre caps with bold type first names. 19 If required, even using specific role titles such as 'anaesthetist, scrub nurse, assistant, radiographer' in an emergency is preferable to announcing to the room.…”