Closed-Loop Communication in Interprofessional Emergency Teams: A Cross-Sectional Observation Study on the Use of Closed-Loop Communication Among Anesthesia Personnel

Abstract

Objectives: Communication failure is one of the most common causes of adverse events in hospitals and poses a direct threat to patient safety. Research recommends the use of closed-loop communication in interprofessional emergency teams to prevent such events. Multiple studies have examined closed-loop communication during simulation training, but few have investigated its use in clinical practice. The aim of the study was to explore the use of closed-loop communication by anesthesia personnel in real-life interprofessional emergency teams.Methods: This study had a descriptive, cross-sectional design where structured field observations were used to assess anesthesia personnel's use of closed-loop communication in real-life interprofessional emergency teams. A total of 60 interprofessional teams were observed, including 120 anesthesia personnel at a hospital in South-Eastern Norway. Data were analyzed using descriptive statistics.Results: A total of 1626 call outs were registered, in which closed-loop communication was applied in 45%. Closed-loop communication was used more frequently when call outs were directed using eye contact and when the call outs were medication orders. There was no difference in the use of closed-loop communication between nurse anesthetists and anesthesiologists. Closed-loop communication was used more frequently in cardiac arrest teams than in trauma teams. Conclusions:The findings in this study have contributed knowledge about anesthesia personnel's use of closed-loop communication in real-life interprofessional emergency teams and indicate a potential for improvement. Further research is needed about real-life interprofessional emergency teams' communication patterns and potential barriers from using closed-loop communication, with the aim to improve patient safety.

Transforming Team Performance Through Reimplementation of the Surgical Safety Checklist

“…Initiation of each pause point was used to determine penetration. Fidelity was assessed based on the number of checklist items completed during each pause point, cessation of activity by the OR team, and, as an indicator of engagement, eye contact among team members during SSC performance …”