Checklists, timeouts pre-cardiac surgery; post-op briefings, debriefings suggested to reduce errors
MONDAY, Aug. 5 (HealthDay News) -- Communication skills are the worst aspect of teamwork behavior in the cardiac operating room, and their impact on errors and adverse outcomes indicates a need for interventions to improve teamwork and strengthen communication, according to a scientific statement issued by the American Heart Association and published online Aug. 5 in Circulation.
Joyce A. Wahr, M.D., from the University of Michigan in Ann Arbor, and colleagues reviewed data relating to the risks to patient safety and interventions to reduce perioperative risks and human error in cardiac surgery, specifically focusing on human, environmental, and cultural factors that affect teamwork, particularly communication.
The researchers note that non-technical skills of individuals and teams impact patient safety. Communication skills have been identified as the worst aspect of teamwork behavior within the operating room, and communication errors are the most common cause of errors and adverse outcomes. The key elements of safety can be summarized by the six "C"s: communication, cooperation, coordination, cognition (collective knowledge and understanding), conflict resolution, and coaching (training). Teamwork training efforts have been suggested as a means to reduce human error, but repetition and/or continued coaching is necessary to sustain improvement. Other approaches that could reduce errors include use of checklists and timeouts before surgery, briefings and debriefings after surgery, simulation for assessing and training personnel, and use of structured communication protocols. Communication errors are common during hand-offs, and interventions designed to improve these hand-offs have demonstrated improvements in communication.
"Placing patient safety first will ultimately lead to greater patient satisfaction and better clinical outcomes," the authors write.
Several authors and reviewers disclosed financial ties to the pharmaceutical industry, and serving as expert witnesses.
Full Text (http://circ.ahajournals.org/content/early/2013/08/05/CIR.0b013e3182a38efa.full.pdf+html )