title: Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.
abstract: BACKGROUND
  Teamwork is an important component of patient safety. In fact, communication errors are the most common cause of sentinel events and wrong-site operations in the US. Although efforts to improve patient safety through improving teamwork are growing, there is no validated tool to scientifically measure teamwork in the surgical setting.
  
  
  METHODS
  Operating room personnel in 60 hospitals were surveyed using the Safety Attitudes Questionnaire. Surgeons, anesthesiologists, certified registered nurse anesthetists, and operating room nurses rated their own peers and each other using a 5-point Likert scale (1 = very low, 5 = very high).
  
  
  RESULTS
  Overall response rate was 77.1% (2,135 of 2,769). Ratings of teamwork differed substantially by operating room caregiver type, with the greatest differences in ratings shown by physicians: surgeons (F[4, 2058] = 41.73, p < 0.001), and anesthesiologists (F[4, 1990] = 53.15, p < 0.001). The percent of operating room caregivers rating the quality of collaboration and communication as "high" or "very high" was different by caregiver role and whether they were rating a peer or another type of caregiver: surgeons rated other surgeons "high" or "very high" 85% of the time, and nurses rated their collaboration with surgeons "high" or "very high" only 48% of the time.
  
  
  CONCLUSIONS
  Considerable discrepancies in perceptions of teamwork exist in the operating room, with physicians rating the teamwork of others as good, but at the same time, nurses perceive teamwork as mediocre. Given the importance of communication and collaboration in patient safety, health care organizations should measure teamwork using a scientifically valid method. The Safety Attitudes Questionnaire can be used to measure teamwork, identify disconnects between or within disciplines, and evaluate interventions aimed at improving patient safety.
authors.affiliation: Department of Surgery and Health Policy and Management, Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21224, USA. mmakary1@jhmi.edu
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: J Bryan
authors.initials: JB
authors.lastname: Sexton
authors.forename: Julie A
authors.initials: JA
authors.lastname: Freischlag
authors.forename: Christine G
authors.initials: CG
authors.lastname: Holzmueller
authors.forename: E Anne
authors.initials: EA
authors.lastname: Millman
authors.forename: Lisa
authors.initials: L
authors.lastname: Rowen
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D006801:Humans; D033183:Interdisciplinary Communication; D008505:Medical Staff, Hospital / Q000523:psychology*; D024802:Nurse's Role; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009873:Operating Rooms; D015279:Organizational Culture; D010819:Physician's Role; D019555:Physician-Nurse Relations; D011795:Surveys and Questionnaires