Teamwork lacking in the OR: study

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Surgical teams need to work on working together as a team, reveals a survey in which more than 2,100 surgeons, anesthesiologists, and operating room nurses at 60 hospitals in 16 states were asked to rate communication and teamwork in the OR.

Surgeons received the lowest teamwork ratings—only 65 percent of OR personnel thought surgeons showed a high or very high level of teamwork.

Nurses did much better in the survey. Roughly 83 percent of those surveyed felt general surgical nurses exhibit a high or very high level of teamwork and 85 percent rated certified registered nurse anesthesiologists as displaying a high or very high level of teamwork.

Seventy-nine percent of those surveyed gave anesthesiologists high or very high marks in teamwork. The survey results appear in the Journal of the American College of Surgery this month.

“Teamwork is an important component of patient safety,” note Dr. Martin A. Makary and co-workers from Johns Hopkins University School of Medicine in Baltimore.

Communication errors are the most common cause of OR mistakes, which can lead to operating on the wrong site, leaving sponges and other surgical tools in the patient and overlooking allergies to medications. Research has shown that many of these potentially deadly mistakes can be prevented with better communication and improved hospital systems.

The survey included responses on the Safety Attitudes Questionnaire, which was adapted from an airline industry questionnaire and applied to the health care environment.

“Results, like those telling us that surgeons rate poorly in teamwork, help target areas for improved communication and provide a benchmark for rating strategies aimed at improving patient safety,” Makary said in a statement.

“The bottom line is, you wouldn’t want to fly with a pilot or copilot who wasn’t happy with his working environment and the same applies to the OR,” Makary said.

Makary’s hospital is already acting on the results of this survey, he noted. “Before every operation, we now require a presurgery checklist similar to what pilots do before take-off. This not only minimizes errors but also improves teamwork.”

SOURCE: Journal of the American College of Surgery, May 2006. 

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