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Interprofessional communication in the operating room: a narrative review to advance research and practice

  • Nicole Etherington
  • Michael Wu
  • Olivia Cheng-Boivin
  • Sarah Larrigan
  • Sylvain BoetEmail author
Review Article/Brief Review

Abstract

Purpose

Communication failures are often at the root of adverse events for surgical patients; however, evidence to inform best communication practice in the operating room is relatively limited. This narrative review outlines the importance of interprofessional communication for surgical patient safety, maps its barriers and facilitators, and highlights key strategies for enhancing communication quality in the operating room. Based on this review, a research agenda to inform best practices in interprofessional operating room communication is suggested.

Source

The non-systematic literature search included searches of relevant databases (Medline (via OVID), PubMed, Scopus, and EMBASE, PsycINFO, CINAHL), relevant grey literature sources (e.g., patient safety institute websites), and reference lists of selected articles.

Principal findings

Effective interprofessional communication plays a critical role in the operating room, but faces many challenges at the individual, team, environmental, and organizational level. Factors that support effective communication are less documented than barriers, but include team integration, flattened hierarchies, and structure/standardization. Checklists, safety briefings, and teamwork/communication training are the most common techniques used to improve communication in the operating room. Of all communication techniques, closed-loop communication may be the most practical and inexpensive strategy.

Conclusion

The perioperative community should be encouraged to implement existing effective solutions to improve communication and investigate creative solutions to identified barriers. Improved methods of data collection are needed to enhance evidence quality, increase understanding of communication barriers and facilitators, and identify the best strategy to advance practice.

Communication interprofessionnelle en salle d’opération: un compte rendu narratif pour faire avancer la recherche et la pratique

Résumé

Objectif

Les problèmes de communication sont souvent à l’origine des événements indésirables pour les patients chirurgicaux, et les données probantes pour guider les meilleures pratiques de communication en salle d’opération sont encore relativement limitées. Ce compte rendu narratif souligne l’importance de la communication interprofessionnelle pour la sécurité des patients chirurgicaux, cartographie ses obstacles et les éléments la facilitant, et présente des stratégies clés pour améliorer la qualité de la communication en salle d’opération. Sur la base de ce compte rendu, un agenda de recherche visant à guider les meilleures pratiques en matière de communication interprofessionnelle en salle d’opération est proposé.

Source

Notre recherche de littérature non méthodique s’est intéressée aux bases de données pertinentes (Medline (via OVID), PubMed, Scopus, et EMBASE, PsycINFO, CINAHL), aux sources pertinentes de la littérature grise (par ex., sites Internet des instituts sur la sécurité des patients), et aux listes de références des articles sélectionnés.

Constatations principales

Une communication interprofessionnelle efficace joue un rôle crucial en salle d’opération, mais elle est souvent mise à l’épreuve tant aux niveaux de l’individu, de l’équipe, de l’environnement que de l’organisation. Les facteurs facilitant une communication efficace sont moins documentés que les obstacles; ils comprennent l’intégration de l’équipe, une structure organisationnelle horizontale et la structure/standardisation. Les listes de contrôle, les réunions sur la sécurité et la formation en travail d’équipe/communications sont les techniques les plus fréquemment utilisées pour améliorer la communication en salle d’opération. Parmi toutes les techniques de communication, la communication en circuit fermé pourrait constituer la stratégie la plus pratique et la moins onéreuse.

Conclusion

La communauté périopératoire devrait être encouragée à appliquer les solutions existantes ayant prouvé leur efficacité afin d’améliorer la communication et explorer des solutions créatives pour pallier les obstacles identifiés. De meilleures méthodes de collecte de données sont nécessaires pour améliorer la qualité des données probantes, augmenter la compréhension des obstacles et des aides à la communication, et identifier les meilleures stratégies pour améliorer la pratique.

Notes

Conflicts of interest

None declared.

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.

Author contributions

Sylvain Boet, Nicole Etherington, Olivia Cheng-Boivin, Michael Wu and Sarah Larrigan contributed to all aspects of this manuscript, including study conception and design; acquisition, analysis, and interpretation of data; and drafting the article.

Funding

Dr. Boet was supported by The Ottawa Hospital Anaesthesia Alternate Funds Association.

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Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Clinical Epidemiology ProgramThe Ottawa Hospital Research InstituteOttawaCanada
  2. 2.MD Program, Faculty of MedicineUniversity of OttawaOttawaCanada
  3. 3.Translational and Molecular Medicine Program, Faculty of MedicineUniversity of OttawaOttawaCanada
  4. 4.Department of Anaesthesiology & Pain Medicine, The Ottawa Hospital, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, The Ottawa HospitalUniversity of OttawaOttawaCanada
  5. 5.Department of Innovation in Medical Education, Faculty of MedicineUniversity of OttawaOttawaCanada

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