K Catchpole1, A Mishra, A Handa, P McCulloch. 1. Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom. kencatchpole@nds.ox.ac.uk
Abstract
OBJECTIVE: To analyze the effects of surgical, anesthetic, and nursing teamwork skills on technical outcomes. SUMMARY BACKGROUND DATA: The value of team skills in reducing adverse events in the operating room is presently receiving considerable attention. Current work has not yet identified in detail how the teamwork and communication skills of surgeons, anesthetists, and nurses affect the course of an operation. METHODS: Twenty-six laparoscopic cholecystectomies and 22 carotid endarterectomies were studied using direct observation methods. For each operation, teams' skills were scored for the whole team, and for nursing, surgical, and anesthetic subteams on 4 dimensions (leadership and management [LM]; teamwork and cooperation; problem solving and decision making; and situation awareness). Operating time, errors in surgical technique, and other procedural problems and errors were measured as outcome parameters for each operation. The relationships between teamwork scores and these outcome parameters within each operation were examined using analysis of variance and linear regression. RESULTS: Surgical (F(2,42) = 3.32, P = 0.046) and anesthetic (F(2,42) = 3.26, P = 0.048) LM had significant but opposite relationships with operating time in each operation: operating time increased significantly with higher anesthetic but decreased with higher surgical LM scores. Errors in surgical technique had a strong association with surgical situation awareness (F(2,42) = 7.93, P < 0.001) in each operation. Other procedural problems and errors were related to the intraoperative LM skills of the nurses (F(5,1) = 3.96, P = 0.027). CONCLUSIONS: Detailed analysis of team interactions and dimensions is feasible and valuable, yielding important insights into relationships between nontechnical skills, technical performance, and operative duration. These results support the concept that interventions designed to improve teamwork and communication may have beneficial effects on technical performance and patient outcome.
OBJECTIVE: To analyze the effects of surgical, anesthetic, and nursing teamwork skills on technical outcomes. SUMMARY BACKGROUND DATA: The value of team skills in reducing adverse events in the operating room is presently receiving considerable attention. Current work has not yet identified in detail how the teamwork and communication skills of surgeons, anesthetists, and nurses affect the course of an operation. METHODS: Twenty-six laparoscopic cholecystectomies and 22 carotid endarterectomies were studied using direct observation methods. For each operation, teams' skills were scored for the whole team, and for nursing, surgical, and anesthetic subteams on 4 dimensions (leadership and management [LM]; teamwork and cooperation; problem solving and decision making; and situation awareness). Operating time, errors in surgical technique, and other procedural problems and errors were measured as outcome parameters for each operation. The relationships between teamwork scores and these outcome parameters within each operation were examined using analysis of variance and linear regression. RESULTS: Surgical (F(2,42) = 3.32, P = 0.046) and anesthetic (F(2,42) = 3.26, P = 0.048) LM had significant but opposite relationships with operating time in each operation: operating time increased significantly with higher anesthetic but decreased with higher surgical LM scores. Errors in surgical technique had a strong association with surgical situation awareness (F(2,42) = 7.93, P < 0.001) in each operation. Other procedural problems and errors were related to the intraoperative LM skills of the nurses (F(5,1) = 3.96, P = 0.027). CONCLUSIONS: Detailed analysis of team interactions and dimensions is feasible and valuable, yielding important insights into relationships between nontechnical skills, technical performance, and operative duration. These results support the concept that interventions designed to improve teamwork and communication may have beneficial effects on technical performance and patient outcome.
Authors: Yue-Yung Hu; Sarah Henrickson Parker; Stuart R Lipsitz; Alexander F Arriaga; Sarah E Peyre; Katherine A Corso; Emilie M Roth; Steven J Yule; Caprice C Greenberg Journal: J Am Coll Surg Date: 2015-10-17 Impact factor: 6.113
Authors: Daniel Shouhed; Renaldo Blocker; Alex Gangi; Eric Ley; Jennifer Blaha; Daniel Margulies; Douglas A Wiegmann; Ben Starnes; Cathy Karl; Richard Karl; Bruce L Gewertz; Ken R Catchpole Journal: World J Surg Date: 2014-02 Impact factor: 3.352
Authors: Thomas A D'Agostino; Philip A Bialer; Chasity B Walters; Aileen R Killen; Hrafn O Sigurdsson; Patricia A Parker Journal: AORN J Date: 2017-10 Impact factor: 0.676
Authors: Monica Jain; Brian T Fry; Luke W Hess; Jennifer T Anger; Bruce L Gewertz; Ken Catchpole Journal: J Surg Res Date: 2016-07-04 Impact factor: 2.192