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Communication in the operating theater

Communication in the operating theatre

“The single biggest problem in communication is the illusion that it has taken place (George Bernard Shaw)”

70% of adverse events in surgery are linked to communication failures1. The most frequent cases relate to equipment and keeping team members updated on the current status of the operation2. However, not all communication failures directly impact the quality of patient care. A team of researchers observed 150 hours of surgery and counted 76 instance of communication failure. The most common consequences were inefficiencies and delays3.

Figure 1: Observed consequences of communication failure3

To address the issue, we must first take a step back to understand the root causes. Especially in large hospitals, team members change frequently. I was recently in a surgery where the anaesthetist changed three times during a four-hour surgery. Emergencies as well as an ever-changing schedule lead to situations were surgeons find themselves in team constellations that have never worked together before. Also, inherent differences across the subspecialties of surgery, anaesthesia and nursing contribute to the challenge2. Hierarchy and unfamiliarity with patients have also been identified as further root causes of communication failure in the operating theater4.

Research as well as our own experience at Nodus shows, that shared situational awareness is the key for better communication2. We believe that technology can help facilitate communication and thereby improve patient safety and surgical efficiency. A checklist at the beginning of the surgery makes sure, that the right equipment is available before the operation starts. During the operation, Nodus constantly calculates when the surgery is expected to be completed, limiting interruptions. Also, the current and next step is displayed for everyone to see. Research focusing on this approach has shown that such mechanisms work because they create an open dialog, encourage articulation of concerns, support coordination and enhance the team feeling. Surgical nurses perceive the maximum benefit while anaesthesiologists come in second and surgeons third5. This is not surprising given that surgeons make most decisions in the operating theater while nursing staff and anaesthesiologist find themselves more often as the recipient of information than the other way around.

Let us know if you want to discuss how Nodus can help you improve communication of surgical teams. We are happy to set up a call or give you a demo of our software. Simply click here to contact us.

  1. Gillespie, B., Chaboyter, W., Murray, P. 2010. Enhancing Communication in Surgery Through Team Training Interventions: A Systematic Literature Review. AORN Journal; 92(6): 642-657.
  1. Gillespie, B., Chaboyter, W., Longbottom P., Wallis M. 2019. The impact of organisational and individual factors on team communication in surgery: A qualitative study. International Journal of Nursing Studies; 47: 732-741.
  1. Halverson, A., Casey, J., Anderson, J., et al. 2011. Communication failure in the operating room. Surgery; 149(3): 305-310
  1. Nagpal, K., Vats, A., Lamp, B., et al. 2010. Information Transfer and Communication in Surgery – A Systematic Review. Annals of Surgery; 252(2): 225-239.
  1. Russ, S., Rout, S., Sevdalis, N. 2013. Do Safety Checklists Improve Teamwork and Communication in the Operating Room? A Systematic Review. Annals of Surgery; 258(6): 856-871.