The role of teamwork and non-technical skills for improving emergency surgical outcomes: an international perspective

Abstract

The assurance of patient safety in emergency general surgery remains challenging due to the patients’ high-risk underlying conditions and the wide variability in emergency surgical care provided around the globe. The authors of this article convened as an expert panel on patient safety in surgery at the 8th International Conference of the World Society of Emergency Surgery (WSES) in Edinburgh, Scotland, on September 7–10, 2021. This review article represents the proceedings from the expert panel discussions at the WSES congress and was designed to provide an international perspective on optimizing teamwork and non-technical skills in emergency general surgery.

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

“…Emergency surgery teams are made up of a multidisciplinary group of people from different specialities such as anesthesia, emergency medicine, surgery, nursing, and supporting staff, all of whom provide simultaneous inputs into the trauma assessment and treatment, with a team leader who will be coordinating their activities [ 1 ]. Therefore, in trauma and emergency situations, team dynamics are critical [ 6 ].…”

“…Interestingly, current teaching and assessment approaches for these advanced cognitive skills are subjective, lack standardization, and are vulnerable to errors [ 5 , 6 ]. Therefore, knowledge translation and knowledge transfer mechanisms are cornerstones to allow team members to bridge their differences and communicate effectively, boosting the potential of multidisciplinary teams [ 8 ].…”

“…It has been defined as “a broad representation of viewpoints, socioeconomic backgrounds, gender, sexual orientation, disability status, race, and ethnicity” [ 10 ]. Emergency surgery teams are diverse by definition, as they include professionals of different specialities and variable backgrounds [ 1 ], who do need interpersonal skills [ 5 , 6 ] to ensure effective care to trauma patients. The literature highlights how global performance has been shown to be better when the environment of medical care is diverse, and patient satisfaction is also improved in such contexts [ 11 , 12 ].…”

Why non-technical skills matter in surgery. New paradigms for surgical leaders

“…In the case of surgeons, resilience may be separated into two different levels: self-resilience, required to cope with stress aiming to decrease its impact. In this regard, new skills were needed, out of the usual surgical environment, treating different patients with a totally new and unknown disease, which did require, for instance, even finding “homemade” technical solutions to be protected from it [ 13 – 16 ]; team-resilience, in which surgeons can contribute with valuable skills to enhance team-playing (networking, team working, communication, leadership, among others) [ 3 – 5 , 17 ]. …”

“…The COVID-related publications have exponentially increased the attention of the literature on the relevance of soft or non-technical skills (NTS), defined as “the cognitive and social skills that characterize high performing individuals and teams” [ 3 ] in supporting surgeons in dealing with unexpected situations [ 4 , 5 ]. More in detail, NTS have been considered crucial in defining situation awareness, enhancing decision making, communicating among groups and teams, and fostering leadership [ 3 ].…”