Training OR Staff in Teamwork Markedly Reduces Mortality Rates

Training OR staff on how to work as a team markedly reduces hospital mortality rates, according to a study in the Journal of the American Medical Association.

A specific team-training program, incorporating practices of aviation crews and NASA, helped reduce mortality by 18 percent, compared with 7 percent at hospitals that did not use the program. That amounted to a 50 percent greater decline in the mortality rate. In the training, staff learned how to discuss potential challenges, use checklists and review outcomes after surgery.

Like flight crews, ORs tend to be hierarchical, making staff sometimes hesitant to speak up, said co-author James Bagian, MD, a former NASA astronaut and now the chief patient safety and systems innovation officer at the University of Michigan Health System. "When you look at problems and adverse events in healthcare, most of them have as one of their major causative factors a failure of communication," Dr. Bagian told HealthDay News. "Based on my background in aviation and NASA, it always was stunning to me that in healthcare we were very casual and not rigorous in the way we communicated."

The Medical Team Training program used in the study includes two months of preparation and planning with the hospital's implementation surgical care team, followed by a day-long onsite learning session. Clinicians were trained to work as a team, challenge each other when they identified safety risks, conduct checklist-guided preoperative briefings and postoperative debriefings, and use strategies such as recognizing red flags, rules of conduct for communication, stepping back to reassess a situation and effective communication during care transitions.

Read the JAMA abstract on surgical outcomes.

Read the HealthDay News report on surgical outcomes.

Read on surgical teamwork:

-The Implementation of New Models of Care: Q&A With Iowa Health System CEO Bill Leaver

-5 Practical Tips on Building a Cohesive Team at Your GI/Endoscopy-Driven ASC

-NYC Hospital for Special Surgery's Best Practices Keep SSIs Lowest in the State

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