Department of Surgery, Stanford University School of Medicine, Stanford, California.
Department of Surgery, Stanford University School of Medicine, Stanford, California.
J Surg Res. 2021 Apr;260:237-244. doi: 10.1016/j.jss.2020.11.051. Epub 2020 Dec 23.
Effective teamwork and communication are correlated with improved patient care quality and outcomes. The belief that each team member contributes to excellent patient care in the operating room (OR) leads to a more productive work environment. However, poor teamwork and communication lead to poorer OR outcomes. We qualitatively and quantitatively explored perspectives of three OR professions (nursing, anesthesiology, and surgery) on teamwork and communication in the OR preinterprofessional and postinterprofessional in situ OR simulation.
One-on-one semi-structured interviews were conducted; 14 pre-in situ simulations during July-October 2017 (three surgery, four anesthesiology, and six nursing staff), and 10 post-in situ simulations during August-November 2017 (five surgery, four anesthesiology, and one nursing staff). Themes were identified inductively to create a codebook. The codebook was used to consensus code all interviews. This analysis informed the development of a quantitative survey distributed to all contactable interviewees (22).
Presimulation and postsimulation interview participants concurred on teamwork and communication importance, believed communication to be key to effective teamwork, and identified barriers to communication: lack of cordiality, lack of engagement from other staff, distractions, role hierarchies, and lack of familiarity with other staff. The large majority of survey participants-all having participated in simulations-believed they could use effective communication in their workplace.
Establishing methods for improving and maintaining the ability of OR professionals to communicate with each other is imperative for patient safety. Effective team communication leads to safe and successful outcomes, as well as a productive and supportive OR work environment.
有效的团队合作和沟通与改善患者护理质量和结果相关。每个团队成员都相信自己能为手术室（OR）的患者护理做出卓越贡献，这有助于营造更富有成效的工作环境。然而，团队合作和沟通不佳会导致 OR 结果变差。我们采用定性和定量的方法，探究了手术室（OR）中三个专业（护理、麻醉和外科）在预职业间和职业间现场 OR 模拟前后的团队合作和沟通的观点。
进行了一对一的半结构化访谈；2017 年 7 月至 10 月期间进行了 14 次现场模拟前访谈（3 次外科、4 次麻醉、6 次护理人员），2017 年 8 月至 11 月期间进行了 10 次现场模拟后访谈（5 次外科、4 次麻醉、1 次护理人员）。采用归纳法确定主题以创建代码簿。代码簿用于对所有访谈进行共识编码。这一分析为向所有可联系的受访者（22 人）分发的定量调查提供了信息。
模拟前和模拟后访谈的参与者都认为团队合作和沟通很重要，认为沟通是有效团队合作的关键，并确定了沟通障碍：缺乏亲切、其他员工缺乏参与、分心、角色层次和对其他员工不熟悉。绝大多数参与模拟的调查参与者——他们都参加了模拟——都认为他们可以在工作场所中使用有效的沟通。
建立改善和维持手术室专业人员相互沟通能力的方法对于患者安全至关重要。有效的团队沟通可带来安全且成功的结果，以及富有成效和支持性的手术室工作环境。
