Processes and tools to improve teamwork and communication in surgical settings: a narrative review

Espin, Sherry; Indar, Alyssa; Gross, Marketa; Labricciosa, Antoniette; D'Arpino, Maryanne

doi:10.1136/bmjoq-2020-000937

Cited by 8 publications

(7 citation statements)

References 52 publications

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“…The importance of clear communication in the operating theatre (OT) has been widely recognised ( Espin et al 2020 ). Yet, ineffective communication is a major root cause of surgical adverse outcomes ( Leonard et al 2004 , Wahr et al 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Improving teamwork and communication in the operating room by introducing the theatre cap challenge

Dalen

Swinkels

Coolen

et al. 2022

Journal of Perioperative Practice

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Objective One of the steps of the Surgical Safety Checklist is for the team members to introduce themselves. The objective of this study was to implement a tool to help remember and use each other’s names and roles in the operating theatre. Methods This study was part of a pilot study in which a video and medical data recorder was implemented in one operating theatre and used as a tool for postoperative multidisciplinary debriefings. During these debriefings, name recall was evaluated. Following the implementation of the medical data recorder, this study was started by introducing the theatre cap challenge, meaning the use of name (including role) stickers on the surgical cap in the operating theatre. Findings In total, 41% (n = 40 out of 98) of the operating theatre members were able to recall all the names of their team at the team briefings. On average 44.8% (n = 103) was wearing the name sticker. Conclusions The time-out stage of the Surgical Safety Checklist might be inadequate for correctly remembering and using your operating theatre team members’ names. For this, the theatre cap challenge may help.

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Section: Introductionmentioning

confidence: 99%

Improving teamwork and communication in the operating room by introducing the theatre cap challenge

Dalen

Swinkels

Coolen

et al. 2022

Journal of Perioperative Practice

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“…The use of anonymous staff feedback and rapid engaging techniques are known to contribute for improved service quality. [25,26] The use of anonymous surveys, in PDSA cycles 1 and 2, and continuous engagement via weekly emails, allowed the project to take on board essential feedback that contributed for building the xPIRT toolkit. In the short talk post-survey analysis, all ideas were considered but only some were applied.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Improving the impact of pharmacy interventions in hospitals

Baptista

Williams

Price

2023

Preprint

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The interventions of pharmacy professionals are considered impactful inputs towards optimised patient care and safety, by rationalising prescriptions, enhancing therapeutic choices and reducing and preventing medication errors and adverse effects. Between October 2020 and October 2021, the community hospitals at Powys Teaching Health Board recorded 158 interventions, corresponding to 0.4 interventions per pharmacy staff per week. Predominantly, only two members of the team were recording these pharmacy interventions (PIs). Poor indicative PIs can result in lost opportunities for medication optimisation and prescribing rationalisation, increased costs and unidentified education and training potentials. The aims of this project were (1) to record 180 interventions between 22/11/2021 and 08/04/2022 (20 weeks), corresponding to an average 3-fold increase, compared to the interventions recorded between October 2020 and October 2021 (52 weeks); (2) to have all hospital pharmacy staff recording at least one intervention during the same period. The number of interventions recorded and the number of pharmacy staff recording each intervention were two process measures. The project was completed through two Plan-Do-Study-Act (PDSA) cycles and applied theory on managing change in healthcare. The most successful intervention influencing positively the process measures was the implementation of a new Pharmacy Intervention Record Tool (xPIRT) toolkit that included an online recording tool (xPIRT) and an interactive panel with up-to-date results from all interventions recorded (xPIRT Dashboard). Motivating change was proven to be one of the best determinants of user satisfaction and engagement that contributed to meet the targets of the project. xPIRT Dashboard provided staff the capacity to act on possible personal motivators and the possibility to improving care with medicines on their wards. The implementation of xPIRT toolkit was able to increase the representativity and significance of PIs recorded by the hospital pharmacy team and it is expected to be used for personal professional development, demonstrating team activity and impact, service planning, prescribing practice optimisation, and to identify education/training needs. This toolkit can be easily applied and adapted to other health organisations, settings and services.

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“…While some interventions have been developed over the past decade to guide and improve discharge care transitions in a medical population, none consider the unique needs of a surgical patient . This omission represents an important research and clinical opportunity.…”

Section: Introductionmentioning

confidence: 99%

“…8 While some interventions have been developed over the past decade to guide and improve discharge care transitions in a medical population, none consider the unique needs of a surgical patient. 2,9 This omission represents an important research and clinical opportunity. Only recently, researchers have begun to explore a modified version of one of the currently existing interventions, the Re-Engineered Discharge (RED) intervention, or Project RED, for a surgical population.…”

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confidence: 99%

Mapping the Discharge Process After Surgery

Graham,

Illarmo,

Gray

et al. 2024

JAMA Surg

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ImportanceCare transition models are structured approaches used to ensure the smooth transfer of patients between health care settings or levels of care, but none currently are tailored to the surgical patient. Tailoring care transition models to the unique needs of surgical patients may lead to significant improvements in surgical outcomes and reduced care fragmentation. The first step to developing surgical care transition models is to understand the surgical discharge process.ObjectiveTo map the surgical discharge process in a sample of US hospitals and identify key components and potential challenges specific to a patient’s discharge after surgery.Design, Setting, and ParticipantsThis qualitative study followed a cognitive task analysis framework conducted between January 1, 2022, and April 1, 2023, in Veterans Health Administration (VHA) hospitals. Observations (n = 16) of discharge from inpatient care after a surgical procedure were conducted in 2 separate VHA surgical units. Interviews (n = 13) were conducted among VHA health care professionals nationwide.ExposurePostoperative hospital discharge.Main Outcomes and MeasuresData were coded according to the principles of thematic analysis, and a swim lane process map was developed to represent the study findings.ResultsAt the hospitals in this study, the discharge process observed for a surgical patient involved multidisciplinary coordination across the surgery team, nursing team, case managers, dieticians, social services, occupational and physical therapy, and pharmacy. Important components for a surgical discharge that were not incorporated in the current care transition models included wound care education and supplies; pain control; approvals for nonhome postdischarge locations; and follow-up plans for wounds, ostomies, tubes, and drains at discharge. Potential challenges to the surgical discharge process included social situations (eg, home environment and caregiver availability), team communication issues, and postdischarge care coordination.Conclusions and RelevanceThese findings suggest that current and ongoing studies of discharge care transitions for a patient after surgery should consider pain control; wounds, ostomies, tubes, and drains; and the impact of challenging social situations and interdisciplinary team coordination on discharge success.

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Processes and tools to improve teamwork and communication in surgical settings: a narrative review

Cited by 8 publications

References 52 publications

Improving teamwork and communication in the operating room by introducing the theatre cap challenge

Improving teamwork and communication in the operating room by introducing the theatre cap challenge

Improving the impact of pharmacy interventions in hospitals

Mapping the Discharge Process After Surgery

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