Doc-nurse teamwork cuts down on surgical complications, deaths

Hospital programs aimed at increasing physician-nurse communication and teamwork helped reduce surgery-related complications, including blood clots and infections, according to a study published yesterday in the Archives of Surgery.

Surgical staff at 42 Veterans Health Administration (VHA) facilities implemented a program called the Medical Team Training program, in which the surgical team uses a checklist to discuss the procedure before the surgery, as well as conduct debriefings afterward (sometimes with the patient).

Before the surgical staff members were trained in communication and teamwork, they saw an average of 90 non-fatal complications out of every 1,000 surgeries. After the program, that number dropped to 75 complications, reports Reuters Health.

Regarding morbidity, hospitals that used teamwork training saw a 15 percent decrease in patient deaths, compared to a 10 percent decrease at hospitals that didn't use the program, attributed, partly, to chance.

In addition to the outcomes benefits, researchers noted there are other advantages to implementing such teamwork programs.

"Patients like it, staff like it, it is better for morale," said Dr. Douglas Paull, study researcher and surgeon at the Veterans Health Administration's National Center for Patient Safety in Ann Arbor, Mich. Doctors and nurses "work in teams, we care about one and other and we care about the patient, and it shows and outcomes are better."

Patient safety advocate Dr. Peter Pronovost, a critical care physician at Baltimore's Johns Hopkins University School of Medicine, also stressed that physicians should take input not only from nurses but from patients. "If they're welcoming not only your input but the nurses' input and other members of the care team's input, that's a really positive sign that they're likely to make wise decisions," he said.  

For more information:
- read the Reuters article
- check out the study abstract

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