Bodor Richard, Nguyen Brian J, Broder Kevin
From the *Veterans Affairs San Diego Healthcare System, Division of Plastic Surgery, and †University of California, San Diego, School of Medicine, La Jolla, CA.
Ann Plast Surg. 2017 May;78(5 Suppl 4):S222-S224. doi: 10.1097/SAP.0000000000001092.
Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate.
Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams. Participants also weighed in on the importance of using accurate "names and ranks" for all OR participants.
Each service reliably knew their own team members' names and rank. However, surgery and anesthesia teams displayed decreased knowledge about their lower level trainees, whereas nursing teams performed best, identifying all level nurses present. Deficits occurred whenever participants tried recalling basic identifying data about contributors from any other collaborating team. Typically, misidentified participants were lower level PGY residents working on other teams' services. All survey respondents desired improving systems to better remember "names and ranks" identifications among OR participants, citing both safety and team morale benefits.
Many fail to know the names and ranks of contributors among members of different OR teams. Even our most reliable nursing team was inconsistent at identification information from collaborating practitioners. Despite universally acknowledged benefits, participants rarely learned basic background identification data beyond their own team. Those surveyed all desired improving identifications with suggestions including sterile name and rank tags and proper notification of entry and exit from the OR. Because successful collaborations require appropriate level task delegations, participants believed knowing a resident's name and rank is important not only for team bonding but also for safety. Academia furthermore demands fair performance evaluations, and displaying them clearly improves recall. Refining our own identified gaps in OR communications may demonstrate improved teamwork and safer task delegations and perhaps even stimulate other performance benefits for academic ORs.
多学科团队之间的沟通不畅会影响效率、绩效和士气。学术手术室通常有外科、麻醉和护理团队，每个团队都在指导多名实习生。错误识别住院医师实习生的姓名和“级别”（研究生年级[PGY]）可能会扰乱绩效评估和团队士气，当沟通错误增多时，甚至可能损害优质护理的提供。
我们在手术室进行的调查询问了50名参与者（18名外科医生、14名麻醉医生和18名护理人员），让他们回忆近期合作的手术室团队中人员的基本识别信息，包括提供者姓名和PGY级别。参与者还对在手术室中所有参与者使用准确“姓名和级别”的重要性发表了意见。
每个科室都能可靠地知道自己团队成员的姓名和级别。然而，外科和麻醉团队对低年资实习生的了解较少，而护理团队表现最佳，能识别出所有在场的各级护士。当参与者试图回忆来自任何其他合作团队成员的基本识别信息时，就会出现信息缺失。通常，被错误识别的参与者是在其他科室服务的低年资PGY住院医师。所有调查受访者都希望改进系统，以便更好地记住手术室参与者之间的“姓名和级别”识别信息，认为这对安全和团队士气都有益处。
许多人不知道不同手术室团队成员的姓名和级别。即使是我们最可靠的护理团队，在识别合作医生的信息时也不一致。尽管大家普遍认识到这样做有好处，但参与者很少了解自己团队以外人员的基本背景识别信息。所有接受调查的人都希望改进识别方式，建议包括使用无菌姓名和级别标签，以及正确通知进出手术室的人员。由于成功的合作需要适当的任务分配，参与者认为知道住院医师的姓名和级别不仅对团队凝聚力很重要，对安全也很重要。此外，学术界要求进行公平的绩效评估，清晰展示这些信息有助于提高记忆。改进我们在手术室沟通中发现的不足之处，可能会展现出更好的团队合作和更安全的任务分配，甚至可能为学术手术室带来其他绩效提升。
