A Ward-Round Non-Technical Skills for Surgery (WANTSS) Taxonomy

BACKGROUND: Around half of surgical adverse events occur outside the operating room. However the majority of nontechnical skills (NTS) training programs have been developed for the intraoperative environment. Ward rounds are a crucial part of extraoperative care and to date no specific NTS training manual has been developed targeting emergency general surgical ward rounds. AIM: To develop a NTS taxonomy for emergency general surgical ward rounds that can be used to improve surgical team members' NTS and improve outcomes. METHODS: A literature review of existing NTS taxonomies was conducted, followed by semistructured interviews and observational data collection, to determine good and poor surgical ward-round behaviors. These behaviors were reviewed by a panel of subject matter experts and categorized into a taxonomy, using the Non-Technical Skills for Surgeons taxonomy framework as a guide. RESULTS: The Ward-round Non-Technical Skills for Surgery taxonomy includes examples of good and poor ward-round-specific behaviors, grouped into elements and categories. The taxonomy can be used as both a training and teaching manual for the surgical team. CONCLUSION: Ward rounds are a crucial part of extraoperative surgical care. The Ward-round Non-Technical Skills for Surgery taxonomy provides surgical teams with a manual to help them improve their ward-round NTS. (C) 2019 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.