Promoting teamwork and a culture of safety in the cardiac operating room can improve patient safety, according to an American Heart Association scientific statement published in Circulation.
The American Heart Association reviewed literature on the effect of communication, the physical work environment and organizational culture on patient safety in the cardiac OR. The statement presents five actions that should be taken to improve safety in the cardiac OR, based on the American College of Cardiology Foundation and American Heart Association scheme for the classification of recommendations and level of evidence. The document also includes actions that are reasonable to perform and ones that may be reasonable to perform to improve safety, according to the classification scheme.
Opportunities to facilitate the translation of current knowledge of communication and teamwork into clinical practice
1. Use checklists and/or briefings in every cardiac surgery case, and encourage the use of postoperative debriefings.
2. Implement team training involving all members of the cardiac operative team to improve communication, leadership and situational awareness.
3. Implement formal handoff protocols during transfer of care of cardiac surgical patients to new medical personnel.
Safety culture: Implementation of policies regarding professionalism and quality
4. Implement local institutional policies that define disruptive behavior of medical professionals, and create transparent and formal procedures for addressing unacceptable behaviors and interventions to eliminate them.
5. Every institution should commit to a culture of safety by establishing a robust quality assurance and quality improvement program.
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