Seminars in Colon & Rectal Surgery
Volume 19, Issue 2 , Pages 98-107 , June 2008

Transforming the Operating Room Team Through Simulation Training

  • John T. Paige, MD

      Affiliations

    • Departments of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, and Ochsner Medical Center, New Orleans, LA.
    • Corresponding Author InformationAddress reprint requests to: John Paige, MD, Louisiana State University Health Sciences Center, Department of Surgery, 533 Bolivar Street, Room 508, New Orleans, LA 70112.
    • ,
  • Sheila W. Chauvin, MEd, PhD

      Affiliations

    • Department of Internal Medicine and School of Public Health, Office of Medical Education Research and Development, Louisiana State University Health Sciences Center, New Orleans, LA.

References 

  1. Joint Commission on Accreditation of Healthcare Organizations. Sample outline for a patient safety plan. Website accessed November 28, 2007. URL: http://www.jointcommission.org/PatientSafety/pt_safety_plan.htm
  2. In:  Greiner AC,  Knebel E editor. Health Professions Education: A Bridge to Quality (Institute of Medicine). Washington, DC: National Academies Press; 2003;
  3. Accreditation Council for Graduate Medical Education. Website accessed November 28, 2007. URL: http://www.acgme.org
  4. Baker DP, Gustafson S, Beaubien J, et al: Medical Teamwork and Patient Safety: The Evidence-based Relation. Literature Review. AHRQ Publication No. 05-0053, April 2005. Agency for Healthcare Research and Quality, Rockville, MD. Website accessed November 28, 2007. URL: http://www.ahrq.gov/qual/medteam/
  5. TeamSTEPPS™: Strategies and Tools to Enhance Performance and Patient Safety. July 2007. Agency for Healthcare Research and Quality, Rockville, MD. Website accessed November 28, 2007. URL: http://www.ahrq.gov/qual/teamstepps/
  6. Burke CS, Salas E, Wilson-Donnelly K, et al. How to turn a team of experts into an expert medical team: guidance from the aviation and military communities. Qual Saf Health Care. 2004;13(suppl 1):i96–i104
  7. Sexton JB, Thomas EJ, Helmreich RL. Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ. 2000;320:745–749
  8. Flin R, Fletcher P, McGeorge A, et al. Anaesthetists' attitudes to teamwork and safety. Anaesthesia. 2003;58:233–242
  9. Makary MA, Sexton JB, Freischlag JA, et al. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg. 2006;202:746–752
  10. Undre S, Sevdalis N, Healy AN, et al. Teamwork in the operating theatre: cohesion or confusion?. J Eval Clin Pract. 2006;12:182–189
  11. McDonald R, Waring J, Harrison S, et al. Rules and guidelines in clinical practice: a qualitative study in operating theatres of doctors' and nurses' views. Qual Saf Health Care. 2005;14:290–294
  12. Lingard L, Reznick R, DeVito I, et al. Forming professional identities on the health care team: discursive constructions of the ‘other’ in the operating room. Med Educ. 2002;36:728–734
  13. Flin R, Yule S, McKenzie L, et al. Attitudes to teamwork and safety in the operating theatre. Surgeon. 2006;4:145–151
  14. Lingard L, Espin S, Whyte S, et al. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004;13:330–334
  15. Lingard L, Garwood S, Poenaru D. Tensions influencing operating room team function: does institutional context make a difference?. Med Educ. 2004;38:691–699
  16. Nestel D, Kidd JM. Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview. BMC Nursing. 2006;5:1
  17. Helmrich RL, Davies JM. Team performance in the operating room. In:  Bogner MS editors. Human Error in Medicine. Hillside, NJ: Erlbaum; 1994;p. 225–253
  18. Moorthy K, Munz Y, Adams S, et al. Self-assessment of performance among surgical trainees during simulated procedures in a simulated operating theater. Am J Surg. 2006;192:114–118
  19. Rosenstein AH, O'Daniel M. Impact and implications of disruptive behavior in the perioperative arena. J Am Coll Surg. 2006;203:96–105
  20. Christian CK, Gustafson ML, Roth EM, et al. A prospective study of patient safety in the operating room. Surgery. 2006;139:159–173
  21. Joint Commission on Accreditation of Healthcare Organizations. Root causes of wrong site surgery. Website accessed November 28, 2007. URL: http://www.jointcommission.org/NR/rdonlyres/90B92D9B-9D55-4469-94B1-DA64A8147F74/0/se_rc_wss.jpg
  22. Kwaan MR, Studdert DM, Zinner MJ, et al. Incidence, patterns, and prevention of wrong-site surgery. Arch Surg. 2006;141:352–357
  23. Rogers SO, Gawande AA, Kwaan M, et al. Analysis of surgical errors in closed malpractice claims at 4 liability insurers. Surgery. 2006;140:25–33
  24. Greenberg CC, Regenbogen SE, Studdert DM, et al. Patterns of communication breakdowns resulting in injury to surgical patients. J Am Coll Surg. 2007;204:533–540
  25. Mohr JJ, Batalden PB. Improving safety on the frontline: the role of the clinical microsystem. Qual Saf Health Care. 2002;11:45–50
  26. Gawron VJ, Drury CG, Fairbanks RJ, et al. Medical error and human factors engineering: where are we now?. Am J Med Qual. 2006;21:57–67
  27. Nolan TW. System changes to improve patient safety. BMJ. 2000;320:771–773
  28. Reason J. Human error: models and management. BMJ. 2000;320:768–770
  29. Reason J. Safety in the operating theatre—part 2: human error and organizational failure. Qual Saf Health Care. 2005;14:56–61
  30. Helmreich RL, Merritt AC. Culture at Work in Aviation and Medicine: National, Organizational, and Professional Influences. Aldershot, UK: Ashgate Publishing Ltd; 1998;
  31. van Stralen D: High reliability organizations. Website accessed November 28, 2007. URL: http://www.highreliability.org/articles/HRO%20essay.pdf
  32. Schulman PR. General attributes of safe organizations. Qual Saf Health Care. 2004;13(suppl II):ii39–ii44
  33. Singer SJ, Gaba DM, Geppert JJ, et al. The culture of safety: results of an organization-wide survey in 15 California hospitals. Qual Saf Health Care. 2003;12:112–118
  34. Gaba DM, Singer SJ, Sinaiko AD, et al. Differences in safety climate between hospital personnel and naval aviators. Hum Factors. 2003;45:173–185
  35. Firth-Cozens J. Cultures for improving patient safety through learning: the role of teamwork. Qual Saf Health Care. 2001;10(suppl II):ii26–ii31
  36. Baker DP, Day R, Salas E. Teamwork as an essential component of high-reliability organizations. Health Serv Res. 2006;41:1576–1598
  37. Wilson KA, Burke CS, Priest HA, et al. Promoting health care safety through training high reliability teams. Qual Saf Health Care. 2005;14:303–309
  38. Beaubien JM, Baker DP. The use of simulation for training teamwork skills in health care: how low can you go?. Qual Saf Health Care. 2004;13:51–56
  39. Frankel AS, Leonard MW, Denham CR. Fair and just culture, team behavior, and leadership engagement: the tools to achieve high reliability. Health Serv Res. 2006;41:1691–1709
  40. Rehmann A, Mitman R, Reynolds M. A Handbook of Flight Simulation Fidelity Requirements for Human Factors Research. Wright-Patterson AFB, OH: Crew Systems Ergonomics Information Analysis Center; 1995;Technical Report No. DOT/FAA/CT-TN95/46
  41. Gaba DM, DeAnda A. A comprehensive anesthesia simulation environment: re-creating the operating room for research and training. Anesthesiology. 1988;69:387–394
  42. Cooper JB, Gaba DM. A strategy for preventing anesthesia accidents. Int Anesthesiol Clin. 1989;27:148–152
  43. Holzman RS, Cooper JB, Gaba DM, et al. Anesthesia crisis resource management: real-life simulation training in operating room crises. J Clin Anesth. 1995;7:675–687
  44. Howard SK, Gaba DM, Fish KJ, et al. Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. Aviat Space Environ Med. 1992;63:763–770
  45. Gaba DM, Howard SK, Fish KJ, et al. Simulation-based training in anesthesia crisis resource management (ACRM): a decade of experience. Simul Gaming. 2001;32:175–193
  46. Small SD, Wuerz RC, Simon R, et al. Demonstration of high-fidelity simulation team training for emergency medicine. Acad Emerg Med. 1999;6:312–323
  47. Reznek M, Smith-Coggins R, Howard S, et al. Emergency Medicine Crisis Resource Management (EMCRM): pilot study of a simulation-based crisis management course for emergency medicine. Acad Emerg Med. 2003;10:386–389
  48. Kim J, Neilipovitz D, Cardinal P, et al. A pilot study in high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: the University of Ottawa critical care medicine, high-fidelity simulation, and crisis resource management I study. Crit Care Med. 2006;34:2167–2174
  49. Weinstock PH, Kappus LJ, Kleinman ME, et al. Toward a new paradigm in hospital-based pediatric education: the development of an onsite simulator program. Pediatr Crit Care Med. 2005;6:635–641
  50. Lighthall GK, Barr J, Howard SK, et al. Use of a fully simulated intensive care unit environment for critical event management training for internal medicine residents. Crit Care Med. 2003;31:2437–2443
  51. Crofts JF, Bartlett C, Ellis D, et al. Training for shoulder dystocia: a trial of simulation using low-fidelity and high-fidelity mannequins. Obstet Gynecol. 2006;108:1477–1485
  52. Aggarwal R, Undre S, Moorthy K, et al. The simulated operating theatre: comprehensive training for surgical teams. Qual Saf Health Care. 2004;13:27–32
  53. Moorthy K, Munz Y, Adams S, 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;242:631–639
  54. Shapiro MJ, Morey JC, Small SD, et al. Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum?. Qual Saf Health Care. 2004;13:417–421
  55. Davis C, Gregg A, Thornley D, et al. Initial feedback on MOSES (Multidisciplinary Obstetric Simulated Emergency Scenarios): a course on team training, human behaviour and ‘fire drills’. Anaesthesiology. 2002;96(suppl 1):11;(abstr)
  56. Morgan PJ, Pittini R, Regehr G, et al. Evaluating teamwork in a simulated obstetric environment. Anesthesiology. 2007;106:907–915
  57. Sexton B, Marsch S, Helmreich R, et al: Participant evaluation of Team Oriented Medical Simulation. Website accessed November 28, 2007. URL: http://homepage.psy.utexas.edu/homepage/group/HelmreichLAB/Publications/226.doc
  58. Betzenderfer D: Anesthesia Patient Safety Foundation. Website accessed November 28, 2007. URL: http://www.apsf.org/resource_center/newsletter/1996/spring/apsfled_betzen.html
  59. Undre S, Koutantji M, Sevdalis N, et al. Multidisciplinary crisis simulations: the way forward for training surgical teams. World J Surg. 2007;31:1843–1853
  60. Flanagan B, Joseph M, Bujor M, et al. Attitudes to safety and teamwork in the operating theatre, and the effects of a program of simulation-based team training. In:  Anca JM editors. Multimodal Safety Management and Human Factors. Aldershot, UK: Ashgate Publishing Ltd; 2007;p. 211–220
  61. Paige J, Kozmenko V, Yang T, et al. From the flight deck to the operating room: an initial pilot study of the feasibility and potential impact of true interdisciplinary team training using high-fidelity simulation. J Surg Educ. 2007;64:369–377
  62. Helmreich R, Schaefer HG. Team performance in the operating room. In:  Bogner M editors. Human Error in Medicine. Hillsdale, NJ: Erlbaum; 1994;p. 224–253
  63. Kozmenko V, Hilton CW: The Clinical Model. Patent pending.
  64. Kozmenko V, Paige J, Chauvin S. Initial implementation of mixed reality simulation targeting teamwork and patient safety. Stud Health Technol Inform. 2008;132:216–221
  65. Caroll JS, Quijada MA. Redirecting traditional professional values to support safety: changing organizational culture in health care. Qual Saf Health Care. 2004;13:16–21
  66. Chauvin SW. Disseminating educational research and implementing change in medical education environments. In:  Norman GR,  van der Vleuten CPM,  Newble DI editor. International Handbook of Research in Medical Education. Dordrecht, The Netherlands: Kluwer; 2002;p. 997–1037
  67. Kotter JP. Leading Change. Boston, MA: Harvard Business School Press; 1996;
  68. Rogers EM. Diffusion of Innovations. (ed 4). New York, NY: The Free Press; 1995;

 From Earl K. Long Medical Center, Baton Rouge, LA, affiliated with Louisiana State University Health Sciences, New Orleans, LA.

PII: S1043-1489(08)00022-5

doi: 10.1053/j.scrs.2008.02.006

Seminars in Colon & Rectal Surgery
Volume 19, Issue 2 , Pages 98-107 , June 2008

Article Tools

* Image Usage & Resolution