Cole Etherington1,2, Michael Wu3, Olivia Cheng-Boivin3, Sarah Larrigan4, Sylvain Boet5,6. 1. Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada. 2. Department of Anaesthesiology & Pain Medicine, The Ottawa Hospital, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. 3. MD Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. 4. Translational and Molecular Medicine Program, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. 5. Department of Anaesthesiology & Pain Medicine, The Ottawa Hospital, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. sboet@toh.on.ca. 6. Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. sboet@toh.on.ca.
Abstract
PURPOSE: Communication failures are often at the root of adverse events for surgical patients; however, evidence to inform best communication practice in the operating room is relatively limited. This narrative review outlines the importance of interprofessional communication for surgical patient safety, maps its barriers and facilitators, and highlights key strategies for enhancing communication quality in the operating room. Based on this review, a research agenda to inform best practices in interprofessional operating room communication is suggested. SOURCE: The non-systematic literature search included searches of relevant databases (Medline (via OVID), PubMed, Scopus, and EMBASE, PsycINFO, CINAHL), relevant grey literature sources (e.g., patient safety institute websites), and reference lists of selected articles. PRINCIPAL FINDINGS: Effective interprofessional communication plays a critical role in the operating room, but faces many challenges at the individual, team, environmental, and organizational level. Factors that support effective communication are less documented than barriers, but include team integration, flattened hierarchies, and structure/standardization. Checklists, safety briefings, and teamwork/communication training are the most common techniques used to improve communication in the operating room. Of all communication techniques, closed-loop communication may be the most practical and inexpensive strategy. CONCLUSION: The perioperative community should be encouraged to implement existing effective solutions to improve communication and investigate creative solutions to identified barriers. Improved methods of data collection are needed to enhance evidence quality, increase understanding of communication barriers and facilitators, and identify the best strategy to advance practice.
PURPOSE: Communication failures are often at the root of adverse events for surgical patients; however, evidence to inform best communication practice in the operating room is relatively limited. This narrative review outlines the importance of interprofessional communication for surgical patient safety, maps its barriers and facilitators, and highlights key strategies for enhancing communication quality in the operating room. Based on this review, a research agenda to inform best practices in interprofessional operating room communication is suggested. SOURCE: The non-systematic literature search included searches of relevant databases (Medline (via OVID), PubMed, Scopus, and EMBASE, PsycINFO, CINAHL), relevant grey literature sources (e.g., patient safety institute websites), and reference lists of selected articles. PRINCIPAL FINDINGS: Effective interprofessional communication plays a critical role in the operating room, but faces many challenges at the individual, team, environmental, and organizational level. Factors that support effective communication are less documented than barriers, but include team integration, flattened hierarchies, and structure/standardization. Checklists, safety briefings, and teamwork/communication training are the most common techniques used to improve communication in the operating room. Of all communication techniques, closed-loop communication may be the most practical and inexpensive strategy. CONCLUSION: The perioperative community should be encouraged to implement existing effective solutions to improve communication and investigate creative solutions to identified barriers. Improved methods of data collection are needed to enhance evidence quality, increase understanding of communication barriers and facilitators, and identify the best strategy to advance practice.