The impact of organisational and individual factors on team communication in surgery: a qualitative study.
BACKGROUND
Effective teamwork and communication is a crucial determinant of patient safety in the operating room. Communication failures are often underpinned by the inherent differences in professional practices across disciplines, and the ways in which they collaborate. Despite the overwhelming international support to improve team communication, progress has been slow.


OBJECTIVE
The aim of this paper is to extend understanding of the organisational and individual factors that influence teamwork in surgery.


METHODS
This qualitative study used a grounded theory approach to generate a theoretical model to explain the relations between organisational and individual factors that influence interdisciplinary communication in surgery.


METHODS
A purposive sample of 16 participants including surgeons, anaesthetists, and nurses who worked in an operating room of a large metropolitan hospital in south east Queensland, Australia, were selected.


METHODS
Participants were interviewed during 2008 using semi-structured individual and group interviews. All interviews were recorded and transcribed. Using a combination of inductive and deductive approaches, thematic analyses uncovered individual experiences in association with teamwork in surgery.


RESULTS
Analysis generated three themes that identified and described causal patterns of interdisciplinary teamwork practices; interdisciplinary diversity in teams contributes to complex interpersonal relations, the pervasive influence of the organisation on team cohesion, and, education is the panacea to improving team communications.


CONCLUSIONS
The development of shared mental models has the potential to improve teamwork in surgery, and thus enhance patient safety. This insight presents a critical first step towards the development teambuilding interventions in the operating room that would specifically address communication practices in surgery.
Gillespie
Brigid M
BM
Research Centre for Clinical & Community Practice Innovation & School of Nursing & Midwifery, Griffith University, Gold Coast Campus, Gold Coast, Queensland 4222, Australia. B.Gillespie@griffith.edu.au
Chaboyer
Wendy
W
Longbottom
Paula
P
Wallis
Marianne
M
D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D008505:Medical Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D008875:Middle Aged; D008960:Models, Psychological; D020380:Needs Assessment; D009718:Nurse Administrators / Q000193:education / Q000458:organization & administration / Q000523:psychology; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009873:Operating Rooms / Q000458:organization & administration; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration*; D036301:Qualitative Research; D011793:Queensland; D017751:Safety Management; D011795:Surveys and Questionnaires