Medicine and Health Sciences Commons^™

Error Or "Act Of God"? A Study Of Patients' And Operating Room Team Members' Perceptions Of Error Definition, Reporting, And Disclosure, Sherry Espin, Wendy Levinson, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Calls abound for a culture change in health care to improve patient safety. However, effective change cannot proceed without a clear understanding of perceptions and beliefs about error. In this study, we describe and compare operative team members' and patients' perceptions of error, reporting of error, and disclosure of error. METHODS: Thirty-nine interviews of team members (9 surgeons, 9 nurses, 10 anesthesiologists) and patients (11) were conducted at 2 teaching hospitals using 4 scenarios as prompts. Transcribed responses to open questions were analyzed by 2 researchers for recurrent themes using the grounded-theory method. Yes/no answers were compared across groups …

The Rules Of The Game: Interprofessional Collaboration On The Intensive Care Unit Team, Lorelei Lingard, Sherry Espin, Cathy Evans, Laura Hawryluck

Lorelei Lingard

BACKGROUND: The intensive care unit (ICU) is a nexus for interspecialty and interdisciplinary tensions because of its pivotal role in the care of the hospital's most critically ill patients and in the management of critical care resources. In an environment charged with temporal, financial and professional tensions, learning how to get results collaboratively is a critical aspect of professional competence. This study explored how team members in the ICU interact to achieve daily clinical goals, delineate professional boundaries and negotiate complex systems issues. METHODS: Seven 1-hour focus groups were conducted with ICU team members in two hospitals. Participants consisted of …

Evaluation Of A Preoperative Checklist And Team Briefing Among Surgeons, Nurses, And Anesthesiologists To Reduce Failures In Communication, Lorelei Lingard, Glenn Regehr, Beverley Orser, Richard Reznick, G. Baker, Diane Doran, Sherry Espin, John Bohnen, Sarah Whyte

Lorelei Lingard

OBJECTIVE: To assess whether structured team briefings improve operating room communication.

DESIGN, SETTING, AND PARTICIPANTS: This 13-month prospective study used a preintervention/postintervention design. All staff and trainees in the division of general surgery at a Canadian academic tertiary care hospital were invited to participate. Participants included 11 general surgeons, 24 surgical trainees, 41 operating room nurses, 28 anesthesiologists, and 24 anesthesia trainees.

INTERVENTION: Surgeons, nurses, and anesthesiologists gathered before 302 patient procedures for a short team briefing structured by a checklist. Main Outcome Measure The primary outcome measure was the number of communication failures (late, inaccurate, unresolved, or exclusive communication) …