Communication in the Operating Room: An Assessment of Clinical Quality of Care

Clinical care quality is an element of healthcare that influences patient outcomes, and if improved, could relieve the burden of healthcare costs in the United States. Medical errors due to factors such as wrong-site surgery contribute to the financial burden of hospitals, inefficiency in operating rooms, and negative patient outcomes. The current research explores perioperative clinical care quality through measures related to provider teamwork and communication. Trained research assistants observed communication techniques such as directed communication, closed-loop communication, open-ended questions, and transparent thinking, between surgeons, anesthesiologists, and nursing staff in operating rooms at a large University hospital. Individual categories of providers were rated on a scale including poor, average, good, or outstanding communication. Overall communication and teamwork were also rated on the same scale, including observations of whether standard “checklist items” for procedures were followed. Checklists were tailored to specific points common to all operating room procedures, including pre-induction, pre-incision, and debriefing. Analyses will involve identifying the prevalence of the communication techniques in operating rooms, and identifying whether there is a correlation between outcomes or complications with respect to how well the communication techniques are employed. Analyses will also investigate the relationship between outcomes or avoidable complications and whether checklist items were followed, such as checking site markings or verbally identifying the patient. Understanding these oversights can then be used to prepare new guidelines for healthcare providers, to improve communication and teamwork in the operating room, ultimately improving patient outcomes, reducing medical error, and cutting unnecessary costs in healthcare.