Discrepant Perceptions of Communication, Teamwork and Situation Awareness among Surgical Team Members

Department of Surgery, Erasmus University Medical Center, Post Box 2040, 3000 CA Rotterdam, The Netherlands.
International Journal for Quality in Health Care (Impact Factor: 1.76). 03/2011; 23(2):159-66. DOI: 10.1093/intqhc/mzq079
Source: PubMed


To assess surgical team members' differences in perception of non-technical skills.
Questionnaire design.
Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands.
Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists.
All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT.
Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P < 0.001). Finally, 72-90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate.
This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

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    • "The realization that a "team of experts does not make an expert team" (Burke et al., 2004, p. i97), i.e., that medical skills and knowledge are not sufficient to provide quality care as a team and that Teamwork requires training and management, has been adopted in healthcare much later than in other high-risk organizations, such as aviation (Ramanujam &amp; Rousseau, 2006). Even though healthcare workers agree that Teamwork is an integral part of their job, members of various healthcare professions differ in their perceptions of its quality (Flin et al., 2003;Sexton et al., 2001;Wauben et al., 2011). Teamwork skills are not sufficiently taught at medical and nursing schools. "

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