Surgical team behaviors and patient outcomes

Mazzocco, Karen; Petitti, Diana B.; Fong, Kenneth T.; Bonacum, Doug; Brookey, John; Graham, Suzanne R; Lasky, Robert E.; Sexton, J. Bryan; Thomas, Eric J.

doi:10.1016/j.amjsurg.2008.03.002

Cited by 639 publications

(422 citation statements)

References 15 publications

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“…Composite measures of teamwork across all operative phases were significantly associated with complication or death after adjusting for American Society of Anesthesiologists (ASA) scores (odds ratio 4.82, 95% confidence interval). 6 A similar conclusion was reported in a study based in a large Veterans Affairs (VA) hospital and academic medical center. Surgical teams whose members reported higher levels of communication and collaboration with the attending and resident doctors had decreased risk-adjusted morbidity.…”

supporting

confidence: 62%

Briefings, Checklists, Geese, and Surgical Safety

Karl

2009

Ann Surg Oncol

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supporting

confidence: 62%

Briefings, Checklists, Geese, and Surgical Safety

Karl

2009

Ann Surg Oncol

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“…Mazzocco et al reported that patients of surgical teams with good teamwork profiles experienced better outcomes than those with poor profiles. 19 Observers used a standardized instrument to assess team behaviours, and a retrospective chart review was carried out to measure 30-day outcomes. When composite measures of teamwork were exhibited more frequently, patients had decreased odds of complications or death, even after adjusting for the American Society of Anesthesiologists' score.…”

Section: Physician Behaviour Patterns and Patient Complaints And Litimentioning

confidence: 99%

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Bahaziq

Crosby

2011

Can J Anesth/J Can Anesth

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Purpose In this review, we examine the association between physician professional behaviour and indicators measuring patient outcomes and satisfaction with care as well the potential for complaints, discipline, and litigation against physicians. We also review issues related to the structured teaching of professionalism to anesthesia residents, including resident evaluation. Source A search of the OVID Medline and PubMed databases was carried out using keywords relevant to the topics under consideration. Program directors of Canadian anesthesiology training programs were also surveyed to assess the current state of professionalism training and evaluation in their programs. Principal findings Unprofessional behaviour is frequently manifested in practice by medical students, residents, and physicians, and it is associated with personality characteristics that are evident early in training. There is a correlation between unprofessional physician behaviours and patient dissatisfaction, complaints, and lawsuits as well as adverse outcomes of care. Physician health and workplace relationships are negatively impacted by such behaviours. Canadian program directors recognize the need to approach the teaching of professionalism in an organized fashion during physician training. Conclusions A framework is provided for defining behavioural expectations, and mechanisms are offered for teaching and evaluating behaviours and responding to individuals with behaviours that persistently breach defined expectations. There is a need to define explicitly not only the expectations for behaviour but also the processes by which the behaviours will be assessed and documented. In addition, emphasis is placed on the nature, order, and magnitude of the responses to behaviours that do not meet expectations.

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“…In addition to surgeons' technical proficiency, non‐technical skills have been implicated in clinical outcomes after surgery and operating theatre efficiency. These non‐technical skills include, in addition to teamwork, attitudes towards safety, situational awareness, decision‐making, communication and theatre environment1, 2, 3, 4, 5, 6, 7, 8, 9, 10. This review was designed to focus on teamwork.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

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BackgroundTeamwork in the operating theatre is becoming increasingly recognized as a major factor in clinical outcomes. Many tools have been developed to measure teamwork. Most fall into two categories: self‐assessment by theatre staff and assessment by observers. A critical and comparative analysis of the validity and reliability of these tools is lacking.MethodsMEDLINE and Embase databases were searched following PRISMA guidelines. Content validity was assessed using measurements of inter‐rater agreement, predictive validity and multisite reliability, and interobserver reliability using statistical measures of inter‐rater agreement and reliability. Quantitative meta‐analysis was deemed unsuitable.ResultsForty‐eight articles were selected for final inclusion; self‐assessment tools were used in 18 and observational tools in 28, and there were two qualitative studies. Self‐assessment of teamwork by profession varied with the profession of the assessor. The most robust self‐assessment tool was the Safety Attitudes Questionnaire (SAQ), although this failed to demonstrate multisite reliability. The most robust observational tool was the Non‐Technical Skills (NOTECHS) system, which demonstrated both test–retest reliability (P > 0·09) and interobserver reliability (Rwg = 0·96).ConclusionSelf‐assessment of teamwork by the theatre team was influenced by professional differences. Observational tools, when used by trained observers, circumvented this.

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Surgical team behaviors and patient outcomes

Cited by 639 publications

References 15 publications

Briefings, Checklists, Geese, and Surgical Safety

Briefings, Checklists, Geese, and Surgical Safety

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Systematic review of methods for quantifying teamwork in the operating theatre

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