5 ways to improve patient safety in the OR

Hospitals can prevent medical errors during cardiac surgeries by training operating room staff on how to communicate with one another and work together as a team, according to a new scientific statement by the American Heart Association (AHA).

Joyce A. Wahr, M.D., from the University of Michigan in Ann Arbor, and 20 colleagues reviewed evidence-based research focused on communication within and between operating teams during cardiac surgeries, the physical workspace and the organizational culture of the cardiac operating room. Their findings and recommendations for improving patient safety were published Monday in AHA's journal, Circulation.

Communication failures are the most common cause of problems and often are the root cause of errors and adverse events, according to research. In fact, Wahr and her colleagues say communication skills are the worst aspect of teamwork behavior in the cardiac operating room.

To strengthen communication and teamwork, the research team recommends five strategies for hospitals and the healthcare industry:

  • Use checklists and conduct postoperative debriefings during cardiac surgeries;
  • Train all members of the cardiac operative team on communication, leadership and situational awareness;
  • Set up formal handoff protocols during transfer of the care of cardiac surgical patients to new medical personnel;
  • Hold scenario training for significant and rare nonroutine events (i.e., emergency oxygenator change out); and
  • Conduct studies of teamwork and communication that consider optimal communication models, team-training models, impediments to implementation of formal training in teamwork and communication skills, long-term studies of the sustained impact of such training on provider outcomes, efficacy of formal training in teamwork and communication skills in improving patient outcomes, and set up an anonymous national multidisciplinary event-reporting system to obtain data about events.

The statement was issued days after the release of a new report that rates 2,463 U.S. hospitals in all 50 states based on the quality of surgical care. That study indicates having a popular hospital brand doesn't mean the surgical care provided at a facility is the best.

For more:
- here's the AHA announcement
- read the study and recommendations (.pdf)

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