Bridging the communication gap in the operating room with medical team training.
BACKGROUND
In the operating room (OR), poor communication among the surgeons, anesthesiologists, and nurses may lead to adverse events that can compromise patient safety. A survey performed at our institution showed low communication ratings from surgeons, anesthesiologists, and OR nursing staff. Our objective was to determine if communication in the operating room could be improved through medical team training (MTT).


METHODS
A dedicated training session (didactic instruction, interactive participation, role-play, training films, and clinical vignettes) was offered to the entire surgical service using crew resource management principles. Attendees also were instructed in the principles of change management. A change team was formed to drive the implementation of the principles reviewed through a preoperative briefing conducted among the surgeon, anesthesiologist, and OR nurse. A validated Likert scale survey with questions specific to effective communication was administered to the nurses, anesthesiologists, and surgeons 2 months after the MTT to determine the impact on communication. Data are presented as mean +/- SEM.


RESULTS
There was a significant increase in the anesthesiologist and surgeon communication composite score after medical team training (anesthesia pre-MTT = 2.0 +/- .3, anesthesia post-MTT = 4.5 +/- .6, P <.0008; surgeons pre-MTT = 5.2 +/- .2, surgeons post-MTT = 6.6+/-.3, P <.0004; nurses pre-MTT = 4.3 +/- .3, nurses post-MTT = 4.2 +/- .4, P = .7).


CONCLUSIONS
Medical team training using crew resource management principles can improve communication in the OR, ensuring a safer environment that leads to decreased adverse events.
Awad
Samir S
SS
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, MED VAMC, OCL (112), 2002 Holcombe Blvd., Houston, TX 77030, USA. sawad@bcm.tcm.edu
Fagan
Shawn P
SP
Bellows
Charles
C
Albo
Daniel
D
Green-Rashad
Beverly
B
De la Garza
Marlen
M
Berger
David H
DH
D000776:Anesthesiology / Q000193:education; D004506:Education, Nursing / Q000592:standards; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education; D006801:Humans; D007318:Inservice Training / Q000379:methods / Q000592:standards; D007400:Interprofessional Relations; D009873:Operating Rooms; D010348:Patient Care Team / Q000592:standards*; D017751:Safety Management / Q000592:standards; D011795:Surveys and Questionnaires