Undre Shabnam, Sevdalis Nick, Healey Andrew N, Darzi Sir Ara, Vincent Charles A
Department of Surgical Oncology and Technology, Imperial College, London, UK.
J Eval Clin Pract. 2006 Apr;12(2):182-9. doi: 10.1111/j.1365-2753.2006.00614.x.
The aim of the research that we report here was to empirically assess the cohesiveness of the multidisciplinary operating theatre (OT) team.
We used concepts from the team performance and team mental models literature to assess OT professionals' perceptions of their teamwork, the structure of their teams and their respective roles within them and their teams' performance.
Team structure: OT professionals would welcome a change from the current structure of the team, although there was no agreement on what that structure is. Nurses perceived the team as unitary, surgeons and anaesthetists perceived it as comprising multiple subteams. Team roles: OT professionals tended to overrate their own understanding of their colleagues' role in the OT relative to the role understanding that the colleagues attributed to them. This tendency was especially marked for the surgeons. Team communication and team performance: OT professionals agreed on the relative importance of the various communicating pairs in the OT. Moreover, they were satisfied with the quality of communication among them, except for the communication between the surgeon and the anaesthetist, which received lower ratings. Finally, the quality of the teamwork in the OT was deemed acceptable, although there is room for improvement.
The OT environment need not be as cohesive as previously assumed--a finding that carries implications for the effectiveness of team training interventions. Further research is needed in order to fully comprehend the dynamics of the OT as a working environment and, most importantly, their relation to patient safety.
我们在此报告的研究目的是通过实证评估多学科手术室(OT)团队的凝聚力。
我们运用团队绩效和团队心智模型文献中的概念,来评估手术室专业人员对团队协作、团队结构、他们在团队中的各自角色以及团队绩效的看法。
团队结构:手术室专业人员希望改变当前的团队结构,尽管对于具体的结构形式并未达成共识。护士认为团队是一个整体,而外科医生和麻醉师则认为团队由多个子团队组成。团队角色:手术室专业人员相对于同事对他们角色的理解,往往高估自己对同事在手术室中角色的理解。这种倾向在外科医生中尤为明显。团队沟通与团队绩效:手术室专业人员对手术室中各沟通对子的相对重要性达成了共识。此外,他们对彼此之间的沟通质量感到满意,但外科医生与麻醉师之间的沟通得分较低。最后,手术室团队协作的质量被认为是可以接受的,不过仍有改进空间。
手术室环境的凝聚力未必如先前假设的那样——这一发现对团队培训干预措施的有效性具有启示意义。为了全面理解手术室作为一个工作环境的动态情况,以及最重要的是其与患者安全的关系,还需要进一步研究。