Abstract
This chapter aims to be an introduction into the fundamentals of behavior and communication in the OR, often referred to as “OR etiquette.” We review the evidence behind the increased understanding of the importance of behavior and communication in the OR, including a discussion on the importance of the “safety culture.” Next, we describe the key team members that are encountered in the OR to provide a basic framework for new medical students and residents. Also included is a discussion on communication, skills of leadership and followership, methods of giving and receiving feedback, and available programs for improving team communication and culture. Finally, we provide a few pointers for how OR etiquette can enhance the experience for all. While nothing can substitute the value of spending time in the OR learning these skills firsthand, understanding these basic tenets is an important first step for medical students and residents beginning their surgical training.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Recommended Readings
Gawande A. The checklist manifesto: how to get things right. New York: Metropolitan Books; 2010.
Institute of Medicine (IOM). To err is human: building a safer health system. Washington, DC: The National Academies Press; 2000.
Yule S, Paterson-Brown S. Surgeons’ non-technical skills. Surg Clin North Am. 2012;92(1):37–50.
“TeamSTEPPS.” Available at https://www.ahrq.gov/teamstepps.
References
Institute of Medicine (IOM). To err is human: building a safer health system. Washington, DC: The National Academies Press; 2000.
Molina G, Berry WR, Lipsitz SR, Edmondson L, Li Z, Neville BA, et al. Perception of safety of surgical practice among operating room personnel from survey data is associated with all-cause 30-day postoperative death rate in South Carolina. Ann Surg. 2017;266(4):658–66.
Birkmeyer NJ, Finks JF, Greenberg CK, McVeigh A, English WJ, Carlin A, et al. Safety culture and complications after bariatric surgery. Ann Surg. 2013;257(2):260–5.
Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491–9.
WHO surgical safety checklist and implementation manual. Available from, http://www.who.int/patientsafety/safesurgery/ss_checklist/en/.
Pugel AE, Simianu VV, Flum DR, Patchen Dellinger E. Use of the surgical safety checklist to improve communication and reduce complications. J Infect Public Health. 2015;8(3):219–25.
Haugen AS, Softeland E, Almeland SK, Sevdalis N, Vonen B, Eide GE, et al. Effect of the World Health Organization checklist on patient outcomes: a stepped wedge cluster randomized controlled trial. Ann Surg. 2015;261(5):821–8.
Erestam S, Haglind E, Bock D, Andersson AE, Angenete E. Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study. Patient Saf Surg. 2017;11:4.
Zingiryan A, Paruch JL, Osler TM, Hyman NH. Implementation of the surgical safety checklist at a tertiary academic center: Impact on safety culture and patient outcomes. Am J Surg. 2016;214(2):193–7.
Biffl WL, Gallagher AW, Pieracci FM, Berumen C. Suboptimal compliance with surgical safety checklists in Colorado: a prospective observational study reveals differences between surgical specialties. Patient Saf Surg. 2015;9(1):5.
Russ S, Rout S, Caris J, Mansell J, Davies R, Mayer E, et al. Measuring variation in use of the WHO surgical safety checklist in the operating room: a multicenter prospective cross-sectional study. J Am Coll Surg. 2015;220(1):1–11.e4.
Gitelis ME, Kaczynski A, Shear T, Deshur M, Beig M, Sefa M, et al. Increasing compliance with the World Health Organization surgical safety checklist-a regional health system’s experience. Am J Surg. 2017;214(1):7–13.
Gibbons A, Bryant D. Followership: the forgotten part of doctors’ leadership. BMJ Careers. 2012;19:2012.
Klingensmith ME. Leadership and followership in surgical education. Am J Surg. 2016;213(2):207–11.
Yule S, Paterson-Brown S. Surgeons’ non-technical skills. Surg Clin North Am. 2012;92(1):37–50.
Hull L, Arora S, Aggarwal R, Darzi A, Vincent C, Sevdalis N. The impact of nontechnical skills on technical performance in surgery: a systematic review. J Am Coll Surg. 2012;214(2):214–30.
Team STEPPS. Available from, https://www.ahrq.gov/teamstepps/index.html.
Langenfeld SJ, Cook G, Sudbeck C, Luers T, Schenarts PJ. An assessment of unprofessional behavior among surgical residents on Facebook: a warning of the dangers of social media. J Surg Educ. 2014;71(6):e28–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Ehlers, A.P., Wright, A.S. (2018). Fundamentals of Acceptable Behavior in the Operating Room (Etiquette). In: Palazzo, F. (eds) Fundamentals of General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-75656-1_23
Download citation
DOI: https://doi.org/10.1007/978-3-319-75656-1_23
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-75655-4
Online ISBN: 978-3-319-75656-1
eBook Packages: MedicineMedicine (R0)