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KEYWORDS: COMMUNICATION, DISTRACTIONS, NOISE, OPERATING ROOMS PATIENT OUTCOMES.
ABSTRACT:
The operating room is a complex environment where noise, distractions, and case relevant and irrelevant communication can adversely impact patient care by prolonging surgeries and increasing the risk for adverse outcomes. This article explores the evidence regarding how communication, noise, and distractions impact the multidisciplinary team and patient outcomes and proposes strategies to deal with these workplace variables.
INTRODUCTION
The operating room (OR) is one of the most complex healthcare work environments and is dynamic and very interactive. Physicians and nurses must be able to excel at teamwork and communicate effectively to ensure optimal patient outcomes. Staff interactions and communication include case-relevant, non-case-relevant, and teaching conversations. The OR has, in addition to communication, music playing, loud equipment, and unwarranted traffic. All of these impact staff and patients.1 This article describes communication, noise, and distractions in the OR, the impact they have on staff and patients, and the interventions to improve patient outcomes.
Communication
Communication among the various surgical team members is of the utmost importance in the OR. Case-relevant communication includes discussions about the patient, equipment, and projected outcomes of the case. Communication regarding the case allows the team to prepare for complications and anticipate events. Case-relevant communication starts when the room is being prepared for a patient and continues throughout the perioperative period.2
Ideally, case-relevant communication should promote positive outcomes for the patient and enhance cohesiveness for the surgical team.' Team members must stay engaged in the information that is being shared.3 Communication breakdown frequently occurs regarding equipment issues. Halverson et al.4 found that communication failures in the OR were significantly apparent in equipment and progress reports and led to inefficiencies and procedural delays.
Non-case-relevant communication, or small talk, in the OR can take place throughout the entire case. It can improve interpersonal relationships amongst the staff and improve the relationship of the team.1 Small talk most often occurs when the workload is low, non-stressful, and fairly routine. Often small talk will occur during wound closure when the surgeon is more relaxed and able to visit with the staff at the end of a long case. The attending surgeon will, however, often leave the closure to the resident who may not be as experienced at...