Relationship Between Operating Room Teamwork, Contextual Factors, and Safety Checklist Performance.

Area of Science:

• Healthcare Quality and Safety
• Surgical Outcomes Research
• Teamwork in Medicine

Background:

• Surgical safety checklists (SSCs) are known to reduce complications.
• The mechanism by which SSCs improve outcomes, specifically the role of teamwork, requires further investigation.
• This study aimed to clarify the relationship between teamwork and SSC performance.

Purpose of the Study:

• To examine the association between surgical teamwork and the performance of surgical safety checklists.
• To understand how different aspects of teamwork influence checklist completion.
• To identify factors affecting the relationship between teamwork and checklist adherence.

Main Methods:

• Utilized validated observational tools to assess operating room teams in 10 hospitals.
• Evaluated checklist performance, surgeon buy-in, and four domains of surgical teamwork (leadership, communication, coordination, respect).
• Analyzed data from 207 procedures, controlling for patient and case characteristics.

Main Results:

• Few teams fully completed all SSC items; procedural checks were more common than conversational prompts.
• Surgeon buy-in and teamwork (leadership, communication, coordination, respect) positively correlated with overall checklist completion and conversational prompts.
• Teamwork and surgeon buy-in did not significantly relate to completing procedural checks; patient age and case duration showed some associations.

Conclusions:

• Surgeon buy-in and robust surgical teamwork are crucial for effective use of checklist prompts.
• High-quality teamwork and surgeon engagement are essential for promoting SSC adherence and ensuring surgical safety.
• Findings underscore the importance of fostering a collaborative surgical environment to maximize the benefits of safety checklists.