Medicine and Health Sciences Commons^™

Communication Failures In The Operating Room: An Observational Classification Of Recurrent Types And Effects, Lorelei Lingard, S. Espin, S. Whyte, G. Regehr, G. Baker, R. Reznick, J. Bohnen, B. Orser, D. Doran, E. Grober

Lorelei Lingard

BACKGROUND: Ineffective team communication is frequently at the root of medical error. The objective of this study was to describe the characteristics of communication failures in the operating room (OR) and to classify their effects. This study was part of a larger project to develop a team checklist to improve communication in the OR. METHODS: Trained observers recorded 90 hours of observation during 48 surgical procedures. Ninety four team members participated from anesthesia (16 staff, 6 fellows, 3 residents), surgery (14 staff, 8 fellows, 13 residents, 3 clerks), and nursing (31 staff). Field notes recording procedurally relevant communication events were …

'Slowing Down When You Should': Initiators And Influences Of The Transition From The Routine To The Effortful, Carol-Anne Moulton, Glenn Regehr, Lorelei Lingard, Catherine Merritt, Helen Macrae

Lorelei Lingard

BACKGROUND: 'Slowing down when you should' has been described as marking the transition from 'automatic' to 'effortful' functioning in professional practice. The ability to 'slow down' is hypothesized as an important factor in expert judgment. This study explored the nature of the 'slowing down' phenomenon intraoperatively and its link to surgical judgment.

METHODS: Twenty-eight surgeons across different surgical specialties were interviewed from four hospitals affiliated with a large urban university. In grounded theory tradition, data were collected and analyzed in an iterative design, using a constant comparative approach. Emergent themes were identified and a conceptual framework was developed.

RESULTS: Surgeons …

Effects Of Surgery On The Mental Status Of Older Persons. A Meta-Analytic Review, Arthur G. Cryns, Kevin M. Gorey, Marion Z. Goldstein

Social Work Publications

The data bases of 18 empirical studies were combined into one comprehensive data set and subjected to meta-analysis. The following trends were observed: (1) surgery has a significantly decompensating impact on the mental status of older persons, and the average effect size observed is modest (r = .37); (2) for all mental status measures included in the review (cognition, delirium and affect), effect size appears to be significantly moderated by patient age; (3) patient sex may be predictive of the kind of mental impairment that is most likely to occur within an older surgery population, with women manifesting a greater …