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Improving communication in the operating room

Brigid Gillespie
Photo: Associate Professor Brigid Gillespie
An Australian researcher aims to improve team-work and communication between nurses, anaesthetists and surgeons in the operating room.

Associate Professor Brigid Gillespie, a Senior Research Fellow at Griffith University’s NHMRC Centre for Excellence in Nursing (NCREN), is researching the use of non-technical skills during surgery in the OR.

A former theatre nurse, Assoc Professor Gillespie said there are several issues contributing to miscommunication in the OR.

“You have got so many disciplines working together and all of them have a different focus,” she said.

“The team should function in an inter-dependent way but that doesn’t always happen.

“While we have this overarching goal of providing safe patient care, sometimes our priorities are competing, and what I think I should be doing may not be understood by someone else.”

Assoc Professor Gillespie has conducted several observational studies that measure communication, teamwork and interruptions in the OR at Queensland hospitals since 2007.

She’s also leading a large Australian Research Council-funded observational study at the Gold Coast University Hospital and the Princess Alexandra Hospital to evaluate team training intervention designed to improve surgical team members’ situational awareness.

Assoc Professor Gillespie said the study has found anaesthetists display higher levels of situational awareness, leadership and communication than surgeons.

“For those of us that work in the operating room or have worked in the operating room, we’ve always kind of known that intuitively because people’s roles are so well defined and circumscribed,” she said.

“The surgeons are focused on the surgery even before they get in there, so they are perhaps not as aware of what’s going on around them.”

Assoc Professor Gillespie said nurses are often the conduit of information and communication in the OR.

“Nurses are, in many instances, what holds everyone together in terms of communicating changes,” she said.

“We all think we have the skills in terms of communication, we all think we’re innately good communicators but the research, and not just my research, other people’s research demonstrates that we’re not as good as we think we are and there is room for improvement.”

Assoc Professor Gillespie is also conducting a National Health and Medical Research Council study to investigate the implementation of the mandated surgical safety checklist, which her research shows significantly reduces postoperative complications.

“All of the hospitals to some degree do use it but it does boil down to culture and it’s very context specific,” she said.

“The component that’s done the best is this time out component where it’s like a team huddle and they check - have we got the right patient, what’s the operation that’s being done, what side are we operating on, are there any concerns.

“The checklist gives everybody in the team the opportunity to voice their concerns in a non-threatening way so that everybody is aware - it heightens everybody’s situational awareness in terms of the bigger picture.”

Assoc Professor Gillespie said she hopes her research will eventually be implemented in new clinical guidelines for the operating room.

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords