title: Team communications in surgery - creating a culture of safety.
abstract: As a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: "building shared understandings through open communication"; "managing contextual stressors in a hierarchical environment" and "intermittent membership influences team performance". In creating a safety culture in a healthcare organisation, a team's optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.
authors.affiliation: NHMRC Research Centre for Excellence in Nursing Interventions (NCREN), School of Nursing & Midwifery, Parklands Dr, Griffith University, Gold Coast 4222, Australia. b.gillespie@griffith.edu.au
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Gillespie
authors.forename: Karleen
authors.initials: K
authors.lastname: Gwinner
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
authors.forename: Nicole
authors.initials: N
authors.lastname: Fairweather
mesh_terms: D006801:Humans; D033183:Interdisciplinary Communication; D008505:Medical Staff, Hospital; D009873:Operating Rooms; D015279:Organizational Culture; D061214:Patient Safety; D036301:Qualitative Research; D011793:Queensland; D062606:Tertiary Care Centers