The complexity of measuring interprofessional teamwork in the operating theatre

Abstract

Surgery depends on interprofessional teamwork, which is becoming increasingly specialized. If surgery is to become a highly reliable system, it must adapt and professionals must learn from, and share, tested models of interprofessional teamwork. Trainers also need valid measures of teamwork to assess individual and team performance. However, measurement and assessment of interprofessional teamwork is lacking and interprofessional team training is scarce in the surgical domain. This paper addresses the complexity of measuring interprofessional teamwork in the operating theatre. It focuses mainly on the design and properties of observational assessment tools. The report and analysis serves to inform the researcher or clinician of the issues to consider when designing or choosing from alternative measures of team performance for training or assessment.

Systematic review of methods for quantifying teamwork in the operating theatre

“…The two most commonly used tools were the Observational Teamwork Assessment for Surgery (OTAS)34, 35, 36, 37, 38, 39 52 and the Non‐Technical Skills (NOTECHS) system27, 28, 29, 30, 31, 32, 33.…”

Surgical Team Stability and Risk of Sharps-Related Blood and Body Fluid Exposures During Surgical Procedures

“…25,26 It is possible that the inclusion of all team members in the construction of the team stability index may hide potentially important effects of relations among subgroups. For example, it is possible that familiarity between a surgeon and a scrub nurse is particularly important for safety.…”

Simulated laparoscopic operating room crisis: An approach to enhance the surgical team performance

“…Although there is no one gold standard model of interprofessional teamwork in surgery, a number of observational team skill measures have been adapted for use, not dissimilar to the NOTECHS rating scale applied used here. For example the observational teamwork assessment in surgery (OTAS) developed by Healy et al measures behavioral constructs such as cooperation, communication, monitoring, coordination and timing, and shared leadership [21]. Anesthetist's nontechnical skills assessment (ANTS) [33] measures teamwork and other nontechnical skills of anesthesiologists.…”

“…Anesthesiologists have developed a number of team training simulation models including the anesthesia crisis resource management courses [17] and use CRM training models in the operating room environment [18,19]. The literature on improving patient safety is beginning to recognize medical team training as capable of improving the quality of healthcare [20,21]. One of the contemporary tools that is being developed for surgical task and team training is scenario-based training in virtual operating theaters [4,22].…”

“…One of the critical components that has recently come to the forefront as a determinant of good outcomes in medicine is the reliability, organization, and multidisciplinary integration of healthcare teams [5,6]. This is especially true in operating rooms where the team communication between anesthesia providers, nurses, and surgeons may help or hinder the delivery of patient care [7][8][9][10]. Evidence suggests that communication failures in healthcare contribute to many adverse events in surgery and other specialties [11][12][13][14].…”