Operating room communication and teamwork: An observational pilot study comparing objective and perceived...

Patient safety in the operating room requires effective teamwork and communication. The purpose of this observational pilot study is to identify trends and potential biases of perceived communication effectiveness and teamwork in the operating room, such that education and interventions can be provided for improved teamwork, patient safety, and workplace satisfaction.

Trained observers attended randomly assigned surgical cases over a 3-month period to analyze effectiveness of teamwork, communication, and leadership skills among surgeon, anesthesia, and circulating/scrub nurse teams and complete objective surveys. Subjective surveys were completed anonymously by every member of the team to gauge perceived teamwork, cooperation, and communication among those present. Results were analyzed using t test and analysis of variance.

From 14 cases, 28 objective, and 97 subjective surveys were completed. There were no differences between objective and subjective impressions by respondent age, gender, role, or involvement. However, when the respondent and lead surgeon were the opposite gender, the surgeon was rated less favorably in all categories. Cases longer than 3 hours scored lower on all categories. Circulating/scrub staff scored greatest on completion of checklist items (P < .0001) and communication (P < .001) while surgeons scored highest on teamwork (P < .0001) and leadership (P < .0001).

Gender and age were not factors leading to significant differences between subjective and objective evaluations; however, attending surgeon gender specifically and case duration were associated with subjective communication and teamwork scores. These results identify opportunities for education and training to reduce bias in the operating room.