The impact of organisational and individual factors on team communication in surgery: A qualitative study

Abstract

Background: Effective teamwork and communication is a crucial determinant of patient safety in the operating room. Communication failures are often underpinned by the inherent differences in professional practices across disciplines, and the ways in which they collaborate. Despite the overwhelming international support to improve team communication, progress has been slow. Objective: The aim of this paper is to extend understanding of the organisational and individual factors that influence teamwork in surgery. Design: A grounded theory approach was used. Setting and Participants: A purposive sample of 16 participants including surgeons, anaesthetists, and nurses who worked in an operating room of a large metropolitan hospital in south east Queensland, Australia, were selected. Methods: Participants were interviewed during 2008 using semi-structured individual and group interviews. All interviews were recorded and transcribed. Using a combination of inductive and deductive approaches, thematic analyses uncovered individual experiences in association with teamwork in surgery. Results: Analysis generated three themes which identified and described causal patterns of multidisciplinary teamwork practices; multidisciplinary diversity in teams contributes to complex interpersonal relations, the pervasive influence of the organisation on team cohesion, and, education is the panacea to improving team communications.