Factors Influencing Team Behaviors in Surgery: A Qualitative Study to Inform Teamwork Interventions.
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Authors
Aveling, Emma-Louise
Stone, Juliana
Sundt, Thoralf
Wright, Cameron
Gino, Francesca
Singer, Sara
Publication Date
2018-07Journal Title
The Annals of thoracic surgery
ISSN
0003-4975
Publisher
Elsevier
Volume
106
Issue
1
Pages
115-120
Language
English
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Aveling, E., Stone, J., Sundt, T., Wright, C., Gino, F., & Singer, S. (2018). Factors Influencing Team Behaviors in Surgery: A Qualitative Study to Inform Teamwork Interventions.. The Annals of thoracic surgery, 106 (1), 115-120. https://doi.org/10.1016/j.athoracsur.2017.12.045
Abstract
Background: Surgical excellence demands teamwork. Poor team behaviors negatively affect team performance and are associated with adverse events and worse outcomes. Interventions to improve surgical teamwork focusing on frontline team members’ nontechnical skills have proliferated but shown mixed results. Literature on teamwork in organizations suggests that team behaviors are also contingent on psycho-social, cultural and organizational factors. This study examines factors influencing surgical team behaviors in order to inform more contextually sensitive and effective approaches to optimizing surgical teamwork. Methods: Qualitative study of cardiac surgical teams in a large US teaching hospital included 34 semi-structured interviews. Thematic network analysis was used to examine perceptions of ideal teamwork and factors influencing team behaviors in the OR. Results: Perceptions of ideal teamwork were largely shared, but team members held discrepant views of which team and leadership behaviors enhanced or undermined teamwork. Other factors impacting team behaviors related to: local organizational culture, including management of staff behavior; variable case demands and team members’ technical competence; fitness of organizational structures and processes to support teamwork. These factors affected perceptions of what constituted optimal interpersonal and team behaviors in the OR. Conclusions: Team behaviors are contextually contingent and organizationally determined, and beliefs about optimal behaviors are not necessarily shared. Interventions to optimize surgical teamwork requires establishing consensus regarding best practice, ability to adapt as circumstances require, and organizational commitment to addressing contextual factors that impact teams.
Keywords
Humans, Risk Factors, Attitude of Health Personnel, Cooperative Behavior, Leadership, Interprofessional Relations, Task Performance and Analysis, Thoracic Surgery, Qualitative Research, Clinical Competence, Hospitals, Teaching, Operating Rooms, Medical Errors, Organizational Culture, Patient Care Team, United States, Female, Male, Interviews as Topic
Identifiers
External DOI: https://doi.org/10.1016/j.athoracsur.2017.12.045
This record's URL: https://www.repository.cam.ac.uk/handle/1810/277065
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Licence URL: http://creativecommons.org/licenses/by-nc-nd/4.0/