Cargando…
Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room
OBJECTIVES: To predict the amount of teamwork that takes place throughout a surgery, based on performing a preoperative safety standards (surgical safety checklist and surgical count) and to explore factors affecting patient safety and staff psychological safety during a surgery, based on interprofe...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816421/ https://www.ncbi.nlm.nih.gov/pubmed/36620282 http://dx.doi.org/10.3389/fpubh.2022.1060473 |
_version_ | 1784864526516092928 |
---|---|
author | Arad, Dana Finkelstein, Adi Rozenblum, Ronen Magnezi, Racheli |
author_facet | Arad, Dana Finkelstein, Adi Rozenblum, Ronen Magnezi, Racheli |
author_sort | Arad, Dana |
collection | PubMed |
description | OBJECTIVES: To predict the amount of teamwork that takes place throughout a surgery, based on performing a preoperative safety standards (surgical safety checklist and surgical count) and to explore factors affecting patient safety and staff psychological safety during a surgery, based on interprofessional teamwork. METHODS: This mixed methods study included quantitative and qualitative analyses. Quantitative data included 2,184 direct observations of surgical cases with regard to the performance of safety standards during surgeries in 29 hospitals, analyzed using multivariate binary logistic regressions. Qualitative data were obtained from an analysis of 25 semi-structured interviews with operating room (OR) clinicians and risk managers, using an inductive thematic analysis approach. RESULTS: Analysis of the OR observations revealed that a lack of teamwork in the preoperative “sign-in” phase doubled the chances of there being a lack of teamwork during surgery [odds ratio = 1.972, 95% confidence interval (CI) 1.741, 2.233, p < 0.001] and during the “time-out” phase (odds ratio = 2.142, 95% CI 1.879, 2.441, p < 0.001). Consistent presence of staff during surgery significantly increased teamwork, by 21% for physicians and 24% for nurses (p < 0.05), but staff turnover significantly decreased teamwork, by 73% for physicians (p < 0.05). Interview data indicated that patient safety and staff psychological safety are related to a perception of a collaborative team role among OR staff, with mutual commitment and effective interprofessional communication. CONCLUSIONS: Healthcare organizations should consider the key finding of this study when trying to identify factors that affect teamwork during a surgery. Effective preoperative teamwork positively affects intraoperative teamwork, as does the presence of more clinicians participating in a surgery, with no turnover. Other factors include working in a fixed, designated team, led by a surgeon, which functions with effective interprofessional communication that promotes patient safety and staff psychological safety. |
format | Online Article Text |
id | pubmed-9816421 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98164212023-01-07 Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room Arad, Dana Finkelstein, Adi Rozenblum, Ronen Magnezi, Racheli Front Public Health Public Health OBJECTIVES: To predict the amount of teamwork that takes place throughout a surgery, based on performing a preoperative safety standards (surgical safety checklist and surgical count) and to explore factors affecting patient safety and staff psychological safety during a surgery, based on interprofessional teamwork. METHODS: This mixed methods study included quantitative and qualitative analyses. Quantitative data included 2,184 direct observations of surgical cases with regard to the performance of safety standards during surgeries in 29 hospitals, analyzed using multivariate binary logistic regressions. Qualitative data were obtained from an analysis of 25 semi-structured interviews with operating room (OR) clinicians and risk managers, using an inductive thematic analysis approach. RESULTS: Analysis of the OR observations revealed that a lack of teamwork in the preoperative “sign-in” phase doubled the chances of there being a lack of teamwork during surgery [odds ratio = 1.972, 95% confidence interval (CI) 1.741, 2.233, p < 0.001] and during the “time-out” phase (odds ratio = 2.142, 95% CI 1.879, 2.441, p < 0.001). Consistent presence of staff during surgery significantly increased teamwork, by 21% for physicians and 24% for nurses (p < 0.05), but staff turnover significantly decreased teamwork, by 73% for physicians (p < 0.05). Interview data indicated that patient safety and staff psychological safety are related to a perception of a collaborative team role among OR staff, with mutual commitment and effective interprofessional communication. CONCLUSIONS: Healthcare organizations should consider the key finding of this study when trying to identify factors that affect teamwork during a surgery. Effective preoperative teamwork positively affects intraoperative teamwork, as does the presence of more clinicians participating in a surgery, with no turnover. Other factors include working in a fixed, designated team, led by a surgeon, which functions with effective interprofessional communication that promotes patient safety and staff psychological safety. Frontiers Media S.A. 2022-12-23 /pmc/articles/PMC9816421/ /pubmed/36620282 http://dx.doi.org/10.3389/fpubh.2022.1060473 Text en Copyright © 2022 Arad, Finkelstein, Rozenblum and Magnezi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Arad, Dana Finkelstein, Adi Rozenblum, Ronen Magnezi, Racheli Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room |
title | Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room |
title_full | Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room |
title_fullStr | Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room |
title_full_unstemmed | Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room |
title_short | Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room |
title_sort | patient safety and staff psychological safety: a mixed methods study on aspects of teamwork in the operating room |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816421/ https://www.ncbi.nlm.nih.gov/pubmed/36620282 http://dx.doi.org/10.3389/fpubh.2022.1060473 |
work_keys_str_mv | AT araddana patientsafetyandstaffpsychologicalsafetyamixedmethodsstudyonaspectsofteamworkintheoperatingroom AT finkelsteinadi patientsafetyandstaffpsychologicalsafetyamixedmethodsstudyonaspectsofteamworkintheoperatingroom AT rozenblumronen patientsafetyandstaffpsychologicalsafetyamixedmethodsstudyonaspectsofteamworkintheoperatingroom AT magneziracheli patientsafetyandstaffpsychologicalsafetyamixedmethodsstudyonaspectsofteamworkintheoperatingroom |