Theatre teams

At Orange County Hospital in the United States, theatre teams have used a routine pre-operative briefing for many years (Leonard, Graham and Bonacum, 2004). Their peri-operative briefing checklist highlights a number of the key themes we have discussed the team first sets out exactly what will... 

At UCLH, operating theatre teams led the adaptation and implementation of the checklist. Most notably, implementation did not focus on the checklist per se, but on resolving issues with poor communication, teamwork and culture in the operating theatres. Whilst the checklist provides a platform for structuring team communication, the hospital had a clear goal that bigger cultural issues needed to be addressed in order to improve patient safety. 

Training was not a one off event. Following the simulation training, checklist mentors worked with theatre teams during cases to resolve issues with the checklist and to provide real time feedback. 

Story-telling was used to spread the word about successful interventions where, for example, a scrub nurse had constructively challenged a consnltant and thwarted a potential incident. A newsletter was prodnced called It s complicated which shared good practice and enabled theatre teams to learn from each other. 

The sessions were conducted by certified healthcare CRM instructors, all of whom were experienced members of the operating theatre team. As such they had insight into the unique problems encountered in the operating theatre environment. 

In 1924 Alexanderson began his television research. By 1927 his group was able to broadcast mechanical television into the home and in 1930 General Electric gave the first large screen demonstration of television in a theatre in Schenectady. His team then transferred to RCA where they helped develop our modern system of television. 

The operation to implant Erick s artificial tissue units had begun fifteen minutes after his removal from zerotau. He d been in surgery for sixteen hours at one point he had four different surgical teams working on various parts of him. When he came out of theatre, thirty per cent of his body weight was accounted for by artificial tissue. 

Teams, like individuals, may erode or create safety. For instance, in their study of communication in the operating theatre, Lorelei Lingard and colleagues (2004) classified about a quarter of operation relevant communications they observed as communication failures. Events were classified as failures because they were made too late or too early, because essential content was missing. 

Good results were celebrated with a Simunye event for workers and their families, with a braai (BBQ), top band and dancing, fireworks, team-building aerial photograph, and industrial theatre on HIV/AIDS. 

Aggarwal R, et al. The simulated operating theatre comprehensive training for surgical teams. Qual Saf Health Care 2004 13(Suppl. I) i27—32. 

Moorthy K, et al. A human factors analysis of technical and team skills among surgical trainees during procedural simulations in a simulated operating theatre. Ann Surg 2005 242(5) 631. 

Attitudes to Safety and Teamwork in the Operating Theatre, and the Effects of a Program of Simulation-Based Team... 

A Safety Attitudes Questionnaire was administered to operating theatre staff before and after a simulation- based team training program, to assess the effectiveness of the program in changing the safety and teamwork culture. At present, insufficient data are currently available to allow statistically valid conclusions to be drawn. 

To ensure a realistic environment for the participants, flie training took place onsite in a spare operating theatre within the participants normal working environment. This was considered important for logistics reasons to ensure all of flie members of the team would be available to participate. 

During the simulation-based team training, eight half-day sessions were mn for a total of 59 participants. The sessions involved surgical and anaesthetic specialist nursing staff (n = 21 and n = 12 respectively), anaesthetic specialists and trainees (n = 8 and n = 6), theatre technicians (n = 8) and surgical trainees (n = 4). A separate evaluation of the half-day program was provided by 18 of the 59 participants (response rate of 31 per cent) a summary is provided in Table 19.1. 

As in aviation, medical persoimel often work as teams, in operating theatres, emergency rooms and trauma units. In this respect, a team of doctors and nurses... 

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