Early Experience of Peer Advocate Program: Using Quality Improvement to Optimize Behavioral and Communication...

Area of Science:

• Healthcare quality improvement
• Surgical safety
• Team dynamics in medicine

Background:

• The operating room (OR) is a hierarchical environment where surgeon behavior impacts teamwork.
• Communication and behavior issues can lead to safety event reports.
• Interventions are needed to improve OR team function and patient outcomes.

Purpose of the Study:

• To decrease safety event reporting system (SERS) reports related to behavior and communication disconnects in the OR.
• To implement and evaluate a novel intervention for addressing interpersonal issues in the OR setting.
• To foster better team collaboration and patient safety from November 2019 to March 2023.

Main Methods:

• A multidisciplinary team developed a new reporting system separating safety events from behavioral issues.
• Implemented a peer advocate (PA) role to mediate communication and behavior disconnects.
• Utilized plan-do-study-act cycles to refine the PA program and interpersonal skills training.

Main Results:

• The peer advocate program managed 39 disconnects over a 2-year trial.
• Nurses most frequently initiated reported disconnects, while surgeons most frequently identified them.
• A decrease in monthly SERS reports concerning behavior and communication was observed.

Conclusions:

• A multidisciplinary approach successfully created a process to manage OR communication and behavioral concerns.
• The peer advocate program facilitated relationship restoration and de-escalated the use of the SERS for interpersonal issues.
• This intervention enhanced the perioperative environment and team collaboration.