Tiferes Judith, Bisantz Ann M, Guru Khurshid A
Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, Buffalo, New York; ATLAS Program, Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.
Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, Buffalo, New York.
J Surg Res. 2015 May 15;195(2):422-32. doi: 10.1016/j.jss.2015.02.034. Epub 2015 Feb 19.
Communication problems have been systematically linked to human errors in surgery and a deep understanding of the underlying processes is essential. Although a number of tools exist to assess nontechnical skills, methods to study communication and other team-related processes are far from being standardized, making comparisons challenging. We conducted a systematic review to analyze methods used to study events in the operating room (OR) and to develop a synthesized coding scheme for OR team communication.
Six electronic databases were accessed to search for articles that collected individual events during surgery and included detailed coding schemes. Additional articles were added based on cross-referencing. That collection was then classified based on type of events collected, environment type (real or simulated), number of procedures, type of surgical task, team characteristics, method of data collection, and coding scheme characteristics. All dimensions within each coding scheme were grouped based on emergent content similarity. Categories drawn from articles, which focused on communication events, were further analyzed and synthesized into one common coding scheme.
A total of 34 of 949 articles met the inclusion criteria. The methodological characteristics and coding dimensions of the articles were summarized. A priori coding was used in nine studies. The synthesized coding scheme for OR communication included six dimensions as follows: information flow, period, statement type, topic, communication breakdown, and effects of communication breakdown.
The coding scheme provides a standardized coding method for OR communication, which can be used to develop a priori codes for future studies especially in comparative effectiveness research.
沟通问题已被系统地证明与手术中的人为失误有关，深入理解其潜在过程至关重要。尽管存在多种评估非技术技能的工具，但研究沟通及其他团队相关过程的方法远未标准化，这使得比较具有挑战性。我们进行了一项系统综述，以分析用于研究手术室（OR）事件的方法，并为手术室团队沟通制定一种综合编码方案。
检索了六个电子数据库，以查找收集手术期间个体事件并包含详细编码方案的文章。通过交叉引用添加了其他文章。然后根据收集的事件类型、环境类型（真实或模拟）、手术数量、手术任务类型、团队特征、数据收集方法和编码方案特征对该集合进行分类。每个编码方案中的所有维度都根据出现的内容相似性进行分组。对专注于沟通事件的文章中得出的类别进行进一步分析，并综合成一个通用编码方案。
949篇文章中有34篇符合纳入标准。总结了这些文章的方法学特征和编码维度。九项研究使用了先验编码。手术室沟通的综合编码方案包括六个维度，如下所示：信息流、时间段、陈述类型、主题、沟通中断以及沟通中断的影响。
该编码方案为手术室沟通提供了一种标准化的编码方法，可用于为未来研究制定先验编码，尤其是在比较效果研究中。
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