The Effect of Surgeon Workload on Intraoperative Communication Qualities: An Observational Study Using...

Area of Science:

• Cardiothoracic Surgery
• Human Factors in Medicine
• Surgical Team Communication

Background:

• Intraoperative communication is critical for patient safety.
• Workload significantly impacts team dynamics and performance in the operating room.
• Understanding communication shifts during varying surgeon workload is essential for training.

Purpose of the Study:

• To analyze differences in intraoperative communication quality between high and low surgeon workload periods.
• To identify potential deficits in surgical training related to communication under stress.
• To investigate how team members adapt their communication during surgeon high workload.

Main Methods:

• Prospective observational study involving over 100 hours of cardiac surgery.
• Surgeon heart rate variability used to define high and low workload periods.
• Communication transcribed and analyzed for exchange types, response substance, and errors.

Main Results:

• Surgeons showed less substantive responses and directed exchanges during high workload.
• Team members addressed surgeons less frequently by name but replied more substantively.
• Open-loop responses increased, and call-backs became more frequent during high workload.

Conclusions:

• Surgeon communication quality decreases under high workload, impacting team interactions.
• Operating room team members demonstrate adaptive communication strategies, enhancing resilience.
• Real-time workload monitoring is crucial for assessing and training non-technical skills in surgery.