"Disruptive behavior" in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_F2978D6FA041
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
"Disruptive behavior" in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams.
Journal
PloS one
Author(s)
Keller S., Tschan F., Semmer N.K., Timm-Holzer E., Zimmermann J., Candinas D., Demartines N., Hübner M., Beldi G.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2019
Peer-reviewed
Oui
Volume
14
Number
12
Pages
e0226437
Language
english
Notes
Publication types: Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Tense communication and disruptive behaviors during surgery have often been attributed to surgeons' personality or hierarchies, while situational triggers for tense communication were neglected. Goals of this study were to assess situational triggers of tense communication in the operating room and to assess its impact on collaboration quality within the surgical team.
The prospective observational study was performed in two university hospitals in Europe. Trained external observers assessed communication in 137 elective abdominal operations led by 30 different main surgeons. Objective observations were related to perceived collaboration quality by all members of the surgical team. A total of 340 tense communication episodes were observed (= 0.57 per hour); mean tensions in surgeries with tensions was 1.21 per hour. Individual surgeons accounted for 24% of the variation in tensions, while situational aspects accounted for 76% of variation. A total of 72% of tensions were triggered by coordination problems; 21.2% by task-related problems and 9.1% by other issues. More tensions were related to lower perceived teamwork quality for all team members except main surgeons. Coordination-triggered tensions significantly lowered teamwork quality for second surgeons, scrub technicians and circulators.
Although individual surgeons differ in their tense communication, situational aspects during the operation had a much more important influence on the occurrence of tensions, mostly triggered by coordination problems. Because tensions negatively impact team collaboration, surgical teams may profit from improving collaboration, for instance through training, or through reflexivity.
Keywords
Clinical Competence, Communication, Humans, Interprofessional Relations, Operating Rooms/organization & administration, Operating Rooms/standards, Patient Care Team/standards, Problem Behavior, Prospective Studies, Surgeons/psychology, Surgical Procedures, Operative/standards
Pubmed
Open Access
Yes
Create date
23/01/2020 15:18
Last modification date
15/01/2021 7:12
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