Qualitative Analysis of Effective Teamwork in the Operating Room (OR)

OBJECTIVE: To conduct focus group interviews with operating room (OR) personnel to determine components of effective teamwork to inform a revision of a teamwork assessment instrument. DESIGN: Qualitative research study targeting OR personnel using semi-structured focus group interviews of interprofessional OR personnel. Responses were digitally recorded and transcribed. Qualitative analysis was undertaken by 2 reviewers who identified major themes related to effective teamwork. Inter-coder agreement was employed to confirm findings and themes. SETTING: Major academic medical center and Level 1 Trauma Center in Southeastern United States. PARTICIPANTS: Fifteen OR staff members including surgeons, an anesthesiologist, nurse anesthetists, circulating nurses, and scrub technicians. RESULTS: Three focus groups involving 15 individuals (2 surgeons, 1 anesthesiologist, 8 nurse anesthetists, 2 circulating nurses, and 2 surgical technologists) were conducted over a 1-month period in 2017. Four major themes related to effective teamwork emerged from analysis: (1) Smooth flow, (2) United effort, (3) Communication, and (4) Positive attitude. CONCLUSIONS: Among the OR team members, agreement regarding effective teamwork centers around the concepts of smooth procedural flow, unified effort, clear communication, and positive attitude of the team. These findings have helped refine a teamwork instrument to increase its utility for formative use in the clinical environment. (C) 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.