title: Adaptive coordination in surgical teams: an interview study.
abstract: BACKGROUND
  Effective teamwork has been recognised as a major contributor to safe patient care in surgery. Previous research has highlighted the importance of adaptive coordination for effective performance in acute care settings. Expanding this line of research this study explores the coordination behaviours and adaptive coordination strategies employed by surgical teams and identifies relevant situational characteristics influencing those coordination processes.
  
  
  METHODS
  We conducted a qualitative content analysis of semi-structured interviews with 33 surgical team members (nurses and physicians) from different specialties and hospitals.
  
  
  RESULTS
  We identified coordination behaviours (i.e. task management, information management, teaching and leadership) and adaptive coordination strategies triggered by varying requirements due to non-routine events, intraoperative complications and differing level of experience among operating room staff. Interviewees highlighted the importance of effectively managing challenging moments and the supporting effect of positive climate on teamwork.
  
  
  CONCLUSIONS
  This study complements previous research on the non-technical skills underpinning safe performance in surgical teams. It highlights the central role of coordination and points out the ways in which situational variability requires the team to behave adaptively.
authors.affiliation: Industrial Psychology and Human Factors Group, Department of Psychology, University of Fribourg, Fribourg, Switzerland. jasmina.bogdanovic@unifr.ch.
authors.forename: Jasmina
authors.initials: J
authors.lastname: Bogdanovic
authors.affiliation: Industrial Psychology and Human Factors Group, Department of Psychology, University of Fribourg, Fribourg, Switzerland. juliana.perry@outlook.com.
authors.forename: Juliana
authors.initials: J
authors.lastname: Perry
authors.affiliation: Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland. merlin.guggenheim@usz.ch.
authors.forename: Merlin
authors.initials: M
authors.lastname: Guggenheim
authors.affiliation: Institute of Patient Safety, University Hospital Bonn, Bonn, Germany. tmanser@ethz.ch.|Department Management, Technology, and Economics, Zurich, ETH, Switzerland. tmanser@ethz.ch.
authors.forename: Tanja
authors.initials: T
authors.lastname: Manser
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009871:Operating Room Nursing / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D066231:Surgeons / Q000523:psychology*