Training Teams for the Perioperative Environment: A Research Agenda

Abstract

A research agenda for investigating the impact of team-work training on patient safety in the perioperative environment is presented. The current status of teamwork training is reviewed briefly, and conclusions based on existing research are presented. We present a roadmap for future research on how teamwork training should be structured, delivered, and evaluated to optimize patient safety in the operating room. For teamwork skills to be assessed and have credibility, team performance measures must be grounded in team theory, account for individual and team-level performance, capture team process and outcomes, adhere to standards for reliability and validity, and address real or perceived barriers to measurement. The interdisciplinary nature of work in the perioperative environment and the necessity of cooperation among team members play an important role in enabling patient safety and avoiding errors. Teams make fewer mistakes than do individuals, especially when each team member knows his or her responsibilities, as well as those of other team members. However, simply installing a team structure without addressing the organizational context of care--the culture--does not automatically ensure it will operate effectively. Factors associated with the design of teamwork training, measures of training effectiveness, and the assessment process that should be explored in near-term work (1 to 2 years) are addressed. We also address the impact of the organizational environment, including the role of institutional support and culture, that need to be explored in longer term research (3 to 5 years).

A ‘Communication and Patient Safety’ training programme for all healthcare staff: can it make a difference?

“…Published data11–13 now confirm the experience of all clinicians that communication breakdowns are involved in the great majority of adverse patient outcomes. Improving communication skills has been a key objective in bringing ‘crew resource management’,13–15 particularly teamwork training,16 17 to healthcare settings. Recent publications describe promising results in general medical units,18 in operating theatres, and intensive care units 19.…”

Factors that influence the expected length of operation: results of a prospective study

“…While each of these team members is well trained in clinical tasks, they are not purposely trained in applying these skills in a team environment in which there is a high degree of task independence 5. Earlier research indicates that team members from different professional backgrounds often have dissonant perspectives about work roles within the interdisciplinary team 6–8.…”

What Do Surgical Nurses Know About Surgical Residents?

“…In a survey 13 of over 6000 residents about conflict with other professional colleagues, 20% of residents reported a serious conflict with another staff member, 8.9% of whom were nurses. As the number of reported conflicts increased, the number of serious medical errors and adverse patient outcomes also increased.…”

“…[6][7][8][9][10][11][12] A fundamental premise of a productive, collaborative relationship is that members of each team understand the basic attributes of other team members. With regard to the care of the surgical patient, surgical residents and surgical nurses are required to work together more so than any other 2 groups.…”