title: The relationship of the emotional climate of work and threat to patient outcome in a high-volume thoracic surgery operating room team.
abstract: BACKGROUND
  It is widely believed that the emotional climate of surgical team's work may affect patient outcome.
  
  
  OBJECTIVE
  To analyse the relationship between the emotional climate of work and indices of threat to patient outcome.
  
  
  METHODS
  Interventional study.
  
  
  METHODS
  Operating rooms in a high-volume thoracic surgery centre from September 2007 to June 2008.
  
  
  METHODS
  Thoracic surgery operating room teams.
  
  
  METHODS
  Two 90 min team-skills training sessions focused on findings from a standardised safety-culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication and leadership.
  
  
  METHODS
  Relationship of functional or less functional emotional climates of work to indices of threat to patient outcome.
  
  
  RESULTS
  A less functional emotional climate corresponded to more threat to outcome in the sterile surgical environment in the pre-intervention period (p<0.05), but not in the post-intervention or sustaining period of this study. This relationship did not exist in the anaesthesia or circulating environments of the operating room.
  
  
  CONCLUSIONS
  The emotional climate of work in the sterile surgical environment appeared to be related to threat to patient outcome prior to, but not after, a team-training intervention. Further study of the relationship between the emotional climate of work and threat to patient outcome using reproducible methods is required.
authors.affiliation: Department of Anesthesiology, Hospital for Special Surgery, New York, USA. nurokm@hss.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Nurok
authors.forename: Linda A
authors.initials: LA
authors.lastname: Evans
authors.forename: Stuart
authors.initials: S
authors.lastname: Lipsitz
authors.forename: Paul
authors.initials: P
authors.lastname: Satwicz
authors.forename: Andrea
authors.initials: A
authors.lastname: Kelly
authors.forename: Allan
authors.initials: A
authors.lastname: Frankel
mesh_terms: D004644:Emotions; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D010348:Patient Care Team / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*; D019616:Thoracic Surgical Procedures / Q000523:psychology*; D017132:Workplace / Q000523:psychology*