Analyzing interprofessional teamwork in the operating room: An exploratory observational study using conventional and...

Area of Science:

• Healthcare Management
• Patient Safety
• Surgical Team Dynamics

Background:

• Intraoperative teamwork is crucial for ensuring patient safety during surgical procedures.
• Existing methods for assessing teamwork often use rating scales or narrative analysis, with varying levels of detail.
• A need exists to evaluate different tools for their effectiveness in providing feedback to improve surgical teamwork.

Purpose of the Study:

• To compare the utility of two conventional teamwork assessment tools, the Operating Theatre Team Non-Technical Skills Assessment Tool (NOTECHS) and the Team Emergency Assessment Measure (TEAM), with a modified-Systems Engineering Initiative for Patient Safety (SEIPS) model.
• To explore the advantages and disadvantages of each tool in providing feedback for enhancing intraoperative teamwork.
• To characterize surgical teamwork using these diverse assessment approaches.

Main Methods:

• A prospective observational study involving 50 consecutive surgical cases recorded using the OR Black Box® at a Canadian academic hospital.
• Analysis of recorded cases by trained raters using NOTECHS, TEAM, and a modified-SEIPS model.
• Descriptive summarization of teamwork performance and behaviors identified by each tool.

Main Results:

• Both NOTECHS and TEAM indicated consistently high teamwork performance across assessed cases.
• The modified-SEIPS model identified both optimal and suboptimal teamwork behaviors and frequently observed team resilience.
• NOTECHS and TEAM provided summative scores, while SEIPS offered a more nuanced understanding of teamwork processes and influencing factors.

Conclusions:

• While NOTECHS and TEAM offer overall assessments of surgical teamwork, the modified-SEIPS model provides deeper insights into teamwork dynamics and the contextual factors affecting performance.
• The SEIPS model's ability to identify specific behaviors and resilience may enhance the development of targeted interventions for improving intraoperative teamwork.
• Healthcare organizations prioritizing teamwork enhancement may benefit from utilizing the SEIPS model for a more comprehensive understanding of surgical team performance.