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Interdisciplinary teamwork is a key to patient safety in the operating room, ICU, and ER

According to previous studies, 70 to 80 percent of medical errors are related to interpersonal interaction issues. Not surprisingly, interdisciplinary teamwork is a key to patient safety in high-risk hospital areas like the operating room (OR), intensive care unit (ICU), and emergency department (ED). However a survey of 261 nurses at four Midwest hospitals revealed aspects of teamwork in their EDs and ICUs that needed improvement. As part of an effort to implement team training at the hospitals, a group of researchers in Minnesota designed a questionnaire that they administered to the nurses to measure teamwork and patient safety attitudes.

Nearly all the nurses surveyed believed that good communication and coordination among team members were as important as technical proficiency for patient safety. However, many reported reservations about raising patient safety issues with team leaders, confusion around team leadership roles, little emphasis placed on teamwork, too little input into patient care decisions, and dispute resolution that was not focused on patient interests. For example, only two-thirds of nurses agreed that conflicts in their department/unit were resolved based on what was best for the patient rather than who was right.

Overall, between 23 and 33 percent of the nurses rated their experiences with the primary physician, consulting physician/surgeon, and anesthesiologist as low or very low. Thirty percent of them rated their experiences with the nurse manager as low or very low, and only 5 percent rated their experiences with fellow nursing staff as low or very low. Nurses in the ED and ICU were more likely than those in the OR to rate collaboration with the anesthesiologist and certified registered nurse anesthetist as low. The study was supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00036).

See "Measuring teamwork and patient safety attitudes of high-risk areas," by Amer Kaissi, M.P.H., Trista Johnson, Ph.D., and Mark S. Kirschbaum, Ph.D., R.N., in the September 2003 Nursing Economics 21(5), pp. 211-218.

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