Labeled Surgical Caps: A Tool to Improve Perioperative Communication

Wong, Becky J.; Nassar, Aussama K.; Goldhaber-Fiebert, Sara N.

doi:10.1097/aln.0000000000004192

Cited by 3 publications

(9 citation statements)

References 3 publications

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“…○ name/role stickers [54] and name badges ○ names on theatre hats [52,53] ○ white board in theatre with each team member's name on it, updated during the day/night as team members change • Train teams in the concept of the `sterile cockpit´ [7,8] and encourage it's use • Encourage use of closed loop communication within your teams and discuss this with colleagues (Table 4) [65] • Train teams in the use of graded assertiveness tools to help team members to `speak up´when they feel safety is compromised (Table 6) and encourage senior staff to `listen down´for key phrases • Plan a `tea trolley training´project [117] for anaesthetists and theatre staff about graded assertiveness tools (Table 6), closed loop communication (Table 4) or multidisciplinary team capnography trace recognition [118] • Discuss actions in Tables 1-6 with colleagues…”

Section: Design Of Safe Working Environmentmentioning

confidence: 99%

“…Introduce systems which help the team use each other's first names, including: ○name/role stickers [54] and name badges ○names on theatre hats [52, 53] ○white board in theatre with each team member's name on it, updated during the day/night as team members change …”

Section: Strategymentioning

confidence: 99%

“…Can provide an auditory cue for team members that urgent action is required Use team members' first names [52][53][54] Improves communication and flattens the hierarchy within the team Use closed loop communication [65] Improves communication within the team Re-evaluate the situation out loud [7,8] Ensures that the team members are aware of the situation and relevant issues, with a `shared mental model´, and may empower them to speak up if they feel that an issue has not been addressed…”

Section: Actions Benefitsmentioning

confidence: 99%

“…Use cognitive aids, including algorithms and checklists [42] • Ensure that these are printed, laminated and readily available in clinical areas [42,48] or implement specifically designed screens in clinical areas where cognitive aids can be displayed • Nominate one team member to read out the steps of the cognitive aid in an emergency Implement strategies to assist team members to use their colleagues' first names For example, name badges, name/role stickers [54], theatre white boards, pre-list safety briefings [40], named theatre hats [52,53] Implement the `civility saves lives´concepts [60,61] Use strategies to improve situation awareness (Table 1)…”

Section: Team Strategiesmentioning

confidence: 99%

“…Non-technical skills can be improved by team members addressing each other using their first names: this improves communication and role allocation, reduces confusion in an emergency, can improve morale and can promote a strong team safety culture [52][53][54]. Having names clearly displayed on badges, theatre hats [52,53], theatre white boards or on personal protective equipment helps staff to regularly use their team members' first names [54]. Non-technical skills can also be improved by team members routinely verbalising their thoughts and actions, and in doing so sharing their `mental model´ [8,55].…”

Section: Practising Non-technical Skills During Everyday Workmentioning

confidence: 99%

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Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals

et al. 2023

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SummaryHuman factors is an evidence‐based scientific discipline used in safety critical industries to improve safety and worker well‐being. The implementation of human factors strategies in anaesthesia has the potential to reduce the reliance on exceptional personal and team performance to provide safe and high‐quality patient care. To encourage the adoption of human factors science in anaesthesia, the Difficult Airway Society and the Association of Anaesthetists established a Working Party, including anaesthetists and operating theatre team members with human factors expertise and/or interest, plus a human factors scientist, an industrial psychologist and an experimental psychologist/implementation scientist. A three‐stage Delphi process was used to formulate a set of 12 recommendations: these are described using a ‘hierarchy of controls’ model and classified into design, barriers, mitigations and education and training strategies. Although most anaesthetic knowledge of human factors concerns non‐technical skills, such as teamwork and communication, human factors is a broad‐based scientific discipline with many other additional aspects that are just as important. Indeed, the human factors strategies most likely to have the greatest impact are those related to the design of safe working environments, equipment and systems. While our recommendations are primarily provided for anaesthetists and the teams they work with, there are likely to be lessons for others working in healthcare beyond the speciality of anaesthesia.

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Section: Design Of Safe Working Environmentmentioning

confidence: 99%

Section: Strategymentioning

confidence: 99%

Section: Actions Benefitsmentioning

confidence: 99%

Section: Team Strategiesmentioning

confidence: 99%

Section: Practising Non-technical Skills During Everyday Workmentioning

confidence: 99%

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Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals

et al. 2023

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Perceptions of Use of Names, Recognition of Roles, and Teamwork After Labeling Surgical Caps

Wong,

Nassar,

Earley

et al. 2023

JAMA Netw Open

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ImportanceCommunication failures in perioperative areas are common and have negative outcomes for both patients and clinicians. Names and roles of teammates are difficult to remember or discern contributing to suboptimal communication, yet the utility of labeled surgical caps with names and roles for enhancing perceived teamwork and connection is not well studied.ObjectiveTo evaluate the use of labeled surgical caps in name use and role recognition, as well as teamwork and connection, among interprofessional perioperative teammates.Design, Setting, and ParticipantsIn this quality improvement study, caps labeled with names and roles were distributed to 967 interprofessional perioperative clinicians, along with preimplementation and 6-month postimplementation surveys. Conducted between July 8, 2021, and June 25, 2022, at a single large, academic, quaternary health care center in the US, the study comprised surgeons, anesthesiologists, trainees, and all interprofessional hospital staff who work in adult general surgery perioperative areas.InterventionLabeled surgical caps were offered cost-free, although not mandatory, to each interested clinician.Main Outcome and MeasureQuantitative survey of self-reported frequency for name use and role recognition as well as postimplementation sense of teamwork and connection. The surveys also elicited free response comments.ResultsOf the 1483 eligible perioperative clinicians, 967 (65%; 387 physicians and 580 nonphysician staff; 58% female) completed preimplementation surveys and received labeled caps, and 243 of these individuals (51% of physicians and 8% of staff) completed postimplementation surveys. Pre-post results were limited to physicians, due to the low postsurvey staff response rate. The odds of participants reporting that they were often called by their name increased after receiving a labeled cap (adjusted odds ratio [AOR], 13.37; 95% CI, 8.18-21.86). On postsurveys, participants reported that caps with names and roles substantially improved teamwork (80%) and connection (79%) with teammates. Participants who reported an increased frequency of being called by their name had higher odds for reporting improved teamwork (AOR, 3.46; 95% CI, 1.91-6.26) and connection with teammates (AOR, 3.21; 95% CI, 1.76-5.84). Free response comments supported the quantitative data that labeled caps facilitated knowing teammates’ names and roles and fostered a climate of wellness, teamwork, inclusion, and patient safety.Conclusions and RelevanceThe findings of this quality improvement study performed with interprofessional teammates suggest that organizationally sponsored labeled surgical caps was associated with improved teamwork, indicated by increased name use and role recognition in perioperative areas.

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Taking Up the Challenge to Improve Name and Role Recognition in the Operating Room

Thota,

Rabinowitz,

Guttman

2023

J Patient Saf

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The rise of the #TheatreCapChallenge in 2017, which saw participants donning surgical caps labeled with their names and roles, promises to be a seemingly simple intervention aimed at improving operating theater communication and patient safety. This narrative review strives to expand upon the perceived and studied benefits of this intervention and address potential concerns that have arisen with the use of these name and role-labeled surgical caps.

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Labeled Surgical Caps: A Tool to Improve Perioperative Communication

Cited by 3 publications

References 3 publications

Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals

Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals

Perceptions of Use of Names, Recognition of Roles, and Teamwork After Labeling Surgical Caps

Taking Up the Challenge to Improve Name and Role Recognition in the Operating Room

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