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Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.
J Am Coll Surg. 2006 May; 202(5):746-52.JA

Abstract

BACKGROUND

Teamwork is an important component of patient safety. In fact, communication errors are the most common cause of sentinel events and wrong-site operations in the US. Although efforts to improve patient safety through improving teamwork are growing, there is no validated tool to scientifically measure teamwork in the surgical setting.

STUDY DESIGN

Operating room personnel in 60 hospitals were surveyed using the Safety Attitudes Questionnaire. Surgeons, anesthesiologists, certified registered nurse anesthetists, and operating room nurses rated their own peers and each other using a 5-point Likert scale (1 = very low, 5 = very high).

RESULTS

Overall response rate was 77.1% (2,135 of 2,769). Ratings of teamwork differed substantially by operating room caregiver type, with the greatest differences in ratings shown by physicians: surgeons (F[4, 2058] = 41.73, p < 0.001), and anesthesiologists (F[4, 1990] = 53.15, p < 0.001). The percent of operating room caregivers rating the quality of collaboration and communication as "high" or "very high" was different by caregiver role and whether they were rating a peer or another type of caregiver: surgeons rated other surgeons "high" or "very high" 85% of the time, and nurses rated their collaboration with surgeons "high" or "very high" only 48% of the time.

CONCLUSIONS

Considerable discrepancies in perceptions of teamwork exist in the operating room, with physicians rating the teamwork of others as good, but at the same time, nurses perceive teamwork as mediocre. Given the importance of communication and collaboration in patient safety, health care organizations should measure teamwork using a scientifically valid method. The Safety Attitudes Questionnaire can be used to measure teamwork, identify disconnects between or within disciplines, and evaluate interventions aimed at improving patient safety.

Authors+Show Affiliations

Department of Surgery and Health Policy and Management, Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21224, USA. mmakary1@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16648014

Citation

Makary, Martin A., et al. "Operating Room Teamwork Among Physicians and Nurses: Teamwork in the Eye of the Beholder." Journal of the American College of Surgeons, vol. 202, no. 5, 2006, pp. 746-52.
Makary MA, Sexton JB, Freischlag JA, et al. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg. 2006;202(5):746-52.
Makary, M. A., Sexton, J. B., Freischlag, J. A., Holzmueller, C. G., Millman, E. A., Rowen, L., & Pronovost, P. J. (2006). Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. Journal of the American College of Surgeons, 202(5), 746-52.
Makary MA, et al. Operating Room Teamwork Among Physicians and Nurses: Teamwork in the Eye of the Beholder. J Am Coll Surg. 2006;202(5):746-52. PubMed PMID: 16648014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. AU - Makary,Martin A, AU - Sexton,J Bryan, AU - Freischlag,Julie A, AU - Holzmueller,Christine G, AU - Millman,E Anne, AU - Rowen,Lisa, AU - Pronovost,Peter J, PY - 2005/11/15/received PY - 2006/01/20/revised PY - 2006/01/30/accepted PY - 2006/5/2/pubmed PY - 2006/6/9/medline PY - 2006/5/2/entrez SP - 746 EP - 52 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 202 IS - 5 N2 - BACKGROUND: Teamwork is an important component of patient safety. In fact, communication errors are the most common cause of sentinel events and wrong-site operations in the US. Although efforts to improve patient safety through improving teamwork are growing, there is no validated tool to scientifically measure teamwork in the surgical setting. STUDY DESIGN: Operating room personnel in 60 hospitals were surveyed using the Safety Attitudes Questionnaire. Surgeons, anesthesiologists, certified registered nurse anesthetists, and operating room nurses rated their own peers and each other using a 5-point Likert scale (1 = very low, 5 = very high). RESULTS: Overall response rate was 77.1% (2,135 of 2,769). Ratings of teamwork differed substantially by operating room caregiver type, with the greatest differences in ratings shown by physicians: surgeons (F[4, 2058] = 41.73, p < 0.001), and anesthesiologists (F[4, 1990] = 53.15, p < 0.001). The percent of operating room caregivers rating the quality of collaboration and communication as "high" or "very high" was different by caregiver role and whether they were rating a peer or another type of caregiver: surgeons rated other surgeons "high" or "very high" 85% of the time, and nurses rated their collaboration with surgeons "high" or "very high" only 48% of the time. CONCLUSIONS: Considerable discrepancies in perceptions of teamwork exist in the operating room, with physicians rating the teamwork of others as good, but at the same time, nurses perceive teamwork as mediocre. Given the importance of communication and collaboration in patient safety, health care organizations should measure teamwork using a scientifically valid method. The Safety Attitudes Questionnaire can be used to measure teamwork, identify disconnects between or within disciplines, and evaluate interventions aimed at improving patient safety. SN - 1072-7515 UR - https://wwww.unboundmedicine.com/medline/citation/16648014/Operating_room_teamwork_among_physicians_and_nurses:_teamwork_in_the_eye_of_the_beholder_ DB - PRIME DP - Unbound Medicine ER -