Studies Prove Communication and Teambuilding Training a MUST for Surgical And Hospital Staff

Although individual judgment and technical dexterity are obviously important, best surgical outcomes, particularly for complex procedures, reflect the performance of many medical providers before, during and after an operation. Professionalism and a competitive business environment both stimulate medical centers to continuously focus on quality assurance programs, and to improve patient safety. Also, continuing medical education of surgical staff, advances in technology, and classic peer review of adverse outcomes have impacted death and complication rates. However, preventing avoidable harm is still a significant challenge, despite innumerable checklists, preoperative briefings, postoperative debriefings, and team training programs.


That is why a recent report published in the Journal of the American Medical Association from the Veterans Health System is so remarkable. Seventy-four facilities underwent a team-training program comprised of two months of instruction, a one-day conference, and one year of quarterly coaching interviews and audits. The program was aimed at forming a cohesive approach towards improving patient safety protocol performed by surgeons, anesthesiologists, nurses and associated operating room healthcare staff. Over a two-year period, the 30 day mortality rate in 182,409 major surgical procedures at participating hospitals was reduced 18% to an absolute rate, which was only 1/2 the concurrent mortality at hospitals that had not undergone the training. Supporting the value of institutional commitment to this approach was the “dose-response” relationship between successive calendar quarterly training and mortality rate. The death rate progressively decreased with each sequential three-month period of participation. The efficacy of this new approach is more impressive given the fact that the hospitals not yet enlisted had in place what were felt to be effective, up-to-date quality programs.


The secrets to success were frequent and open communication, a decision-making structure that welcomes input collegially, regardless of rank, a just culture towards reporting adverse events, and constant training of all team members that was not limited to new hires. What most distinguished the training protocols was mandatory participation by all team members. In other words, no one was too senior to participate. Furthermore, training sessions were embedded in the workload, not sporadic or after hours.


The lay public may read this information and wonder what the big “breakthrough” is-- don’t surgical teams already “work together?” Do you have to teach medical staff how to talk to each other? The truth is that all the well-meaning medical personnel involved in any operation come from different types of training programs, report to separate administrative departments, are rewarded and disciplined by different criteria, and have varying personal and professional goals; cohesion does not come naturally. But obviously, when the leadership of surgical centers are committed to getting all the team players continuously focused on systematic safety procedures and open communication, not only can workplace morale be enhanced, but patients’ lives can be saved.




By Norman Silverman, MD, with Ryan McKennon, DO and Ren Carlton

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Here at Michigan Physicians Society, we’re dedicated to the financial betterment of physicians by providing continuing education and technology, along with an extensive network of other like-minded professionals in our space....
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