Understanding Barriers and Facilitators to Behavior Change After Implementation of an Interdisciplinary Surgical...

Area of Science:

• Healthcare Quality and Safety
• Surgical Education
• Health Systems Research

Background:

• Nontechnical skills are vital for operating room (OR) quality and patient safety.
• A prior interdisciplinary training program based on the NOTSS taxonomy was developed.
• Understanding the application challenges of these skills in Rwanda was needed.

Purpose of the Study:

• To explore the challenges Rwandan surgical providers faced when applying nontechnical skills post-NOTSS training.
• To assess the implementation of nontechnical skills in surgical care delivery in Rwanda.

Main Methods:

• A sequential exploratory mixed-method study design was employed.
• Qualitative phase used a constructivist grounded theory approach.
• Quantitative survey tool developed from qualitative findings explored implementation themes.

Main Results:

• Facilitators included collaboration with NOTSS-trained colleagues, anticipation, and preparation.
• Barriers comprised poor interdisciplinary communication, hierarchy, workload, and environmental instability.
• Nontechnical skills application enhanced team dynamics, patient safety, and provider empowerment.

Conclusions:

• Surgical providers applied NOTSS-trained skills both inside and outside the OR.
• Human and system-based factors significantly influenced the clinical implementation of nontechnical skills.