Physician communication in the operating room: expanding application of face-negotiation theory to the health communication context.
- Kristin Kirschbaum
- Health communication
BACKGROUND In the operating room (OR), poor communication among the surgeons, anesthesiologists, and nurses may lead to adverse events that can compromise patient safety. A survey performed at our institution showed low communication ratings from surgeons, anesthesiologists, and OR nursing staff. Our objective was to determine if communication in the operating room could be improved through medical team training (MTT). METHODS A dedicated training session (didactic instruction, interactive participation, role-play, training films, and clinical vignettes) was offered to the entire surgical service using crew resource management principles. Attendees also were instructed in the principles of change management. A change team was formed to drive the implementation of the principles reviewed through a preoperative briefing conducted among the surgeon, anesthesiologist, and OR nurse. A validated Likert scale survey with questions specific to effective communication was administered to the nurses, anesthesiologists, and surgeons 2 months after the MTT to determine the impact on communication. Data are presented as mean +/- SEM. RESULTS There was a significant increase in the anesthesiologist and surgeon communication composite score after medical team training (anesthesia pre-MTT = 2.0 +/- .3, anesthesia post-MTT = 4.5 +/- .6, P <.0008; surgeons pre-MTT = 5.2 +/- .2, surgeons post-MTT = 6.6+/-.3, P <.0004; nurses pre-MTT = 4.3 +/- .3, nurses post-MTT = 4.2 +/- .4, P = .7). CONCLUSIONS Medical team training using crew resource management principles can improve communication in the OR, ensuring a safer environment that leads to decreased adverse events.