Journal of the American College of Surgeons
Volume 202, Issue 5 , Pages 746-752 , May 2006

Operating Room Teamwork among Physicians and Nurses: Teamwork in the Eye of the Beholder

Presented at the American College of Surgeons 91st Annual Clinical Congress, San Francisco, CA, October 2005.

  • Martin A. Makary, MD, MPH

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
    • Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
    • Johns Hopkins Quality and Safety Research Group, Johns Hopkins Medical Institutions, Baltimore, MD
    • Corresponding Author InformationCorrespondence address: Martin A Makary, MD, MPH, Department of Surgery and Health Policy and Management, Johns Hopkins University School of Medicine, Johns Hopkins Medical Institutions, 4940 Eastern Ave, Bldg A-5, Baltimore, MD 21224
  • ,
  • J. Bryan Sexton, PhD

      Affiliations

    • Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD
    • Johns Hopkins Quality and Safety Research Group, Johns Hopkins Medical Institutions, Baltimore, MD
  • ,
  • Julie A. Freischlag, MD, FACS

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
  • ,
  • Christine G. Holzmueller, BLA

      Affiliations

    • Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD
    • Johns Hopkins Quality and Safety Research Group, Johns Hopkins Medical Institutions, Baltimore, MD
  • ,
  • E. Anne Millman, MS

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
    • Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
    • Johns Hopkins Quality and Safety Research Group, Johns Hopkins Medical Institutions, Baltimore, MD
  • ,
  • Lisa Rowen, RN, DNSc

      Affiliations

    • Department of Nursing, John Hopkins University School of Nursing, Baltimore, MD
  • ,
  • Peter J. Pronovost, MD, PhD

      Affiliations

    • Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
    • Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD
    • Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
    • Department of Nursing, John Hopkins University School of Nursing, Baltimore, MD
    • Johns Hopkins Quality and Safety Research Group, Johns Hopkins Medical Institutions, Baltimore, MD

Received 15 November 2005 ,Revised 20 January 2006 ,Accepted 30 January 2006.

References 

  1. Gawande AA , Studdert DM , Orav EJ , et al.   Risk factors for retained instruments and sponges after surgery . N Engl J Med . 2003;348:229–235
  2. Gibbs V , Auerbach A . In: The retained surgical sponge . 43: Rockville, MD: AHRQ; 2005;p. 255–258 2001, Available at: www.ahrq.gov/clinic/ptsafety/pdf. Accessed November 1
  3. Edmonds CR , Liguori GA , Stanton MA . Two cases of a wrong-site peripheral nerve block and a process to prevent this complication . Reg Anesth Pain Med . 2005;30:99–103
  4. Joint Commission on Accreditation of Healthcare Organizations . Sentinel events (evaluating cause and planning improvement) . Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 1998;
  5. Saufl NM . Universal protocol for preventing wrong site, wrong procedure, wrong person surgery . J Perianesth Nurs . 2004;19:348–351
  6. Kohn L , Corrigan J , Donaldson M . To err is human (building a safer health system [Institute of Medicine Report]) . Washington, DC: National Academy Press; 1999;
  7. Helmreich RL , Foushee HC , Benson R , Russini W . Cockpit resource management (Exploring the attitude-performance linkage) . Aviat Space Environ Med . 1986;57:1198–1200
  8. Baggs JG , Schmitt MH , Mushlin AI , et al.   Association between nurse-physician collaboration and patient outcomes in three intensive care units . Crit Care Med . 1999;27:1991–1998
  9. Shortell SM , Zimmerman JE , Rousseau DM , et al.   The performance of intensive care units (does good management make a difference?) . Med Care . 1994;32:508–525
  10. Knaus WA , Draper EA , Wagner DP , Zimmerman JE . An evaluation of outcome from intensive care in major medical centers . Ann Intern Med . 1986;104:410–418
  11. DeFontes J , Subida S . Preoperative safety briefing project . Permanente J . 2004;8:21–27
  12. Posner B , Randolph W . Perceived situation moderators of the relationship between role ambiguity, job satisfaction, and effectiveness . J Soc Psychol . 1979;109:237–244
  13. Kivimaki M , Sutinen R , Elovainio M , et al.   Sickness absence in hospital physicians (2 year follow up study on determinants) . Occup Environ Med . 2001;58:361–366
  14. Aiken LH , Clarke SP , Sloane DM , et al.   Nurses’ reports on hospital care in five countries . Health Aff (Millwood) . 2001;20:43–53
  15. Bednash G . The decreasing supply of registered nurses (inevitable future or call to action?) . JAMA . 2000;283:2985–2987
  16. Sexton JB, Thomas EJ, Helmreich RL, et al. Frontline assessments of healthcare culture: Safety Attitudes Questionnaire norms and psychometric properties. Technical report 04-01. The University of Texas Center of Excellence for Patient Safety Research and Practice AHRQ grant no. 1PO1HS1154401. Available at http://www.utpatientsafety.org
  17. Sexton JB , Thomas EJ , Helmreich RL . Error, stress, and teamwork in medicine and aviation (cross sectional surveys) . BMJ . 2000;320:745–749
  18. Thomas EJ , Sexton JB , Helmreich RL . Discrepant attitudes about teamwork among critical care nurses and physicians . Crit Care Med . 2003;31:956–959
  19. Helmreich RL , Merrit AC , Sherman PJ , et al.   In: The flight management attitudes questionnaire (FMAQ) . Austin, TX: University of Texas NASA/UT/FAA; 1993;p. 93–94
  20. Helmreich RL . Cockpit management attitudes . Hum Factors . 1984;26:583–589
  21. Gregorich SE , Helmreich RL , Wilhelm JA . The structure of cockpit management attitudes . J Appl Psychol . 1990;75:682–690
  22. Foushee H . Dyads and triads at 25,000 feet (factors affecting group process and aircrew performance) . Am Psychol . 1984;39:885–893
  23. Pronovost PJ , Weast B , Rosenstein B , et al.   Implementing and validating a comprehensive unit-based safety program . J Patient Saf . 2005;1:33–40
  24. In:  Sexton BJ editors. The better the team the safer the world (golden rules of group interaction) . Germany: Ladenburg; 2004;
  25. de Leval MR , Carthey J , Wright DJ , et al.   Human factors and cardiac surgery (a multicenter study) . J Thorac Cardiovasc Surg . 2000;119:661–672
  26. Helmreich R , Sexton J . In:  Dietrich R ,  Childress T editor. Group interaction under threat and high workload . Aldershot, UK: Ashgate Publishing Limited; 2004;
  27. Helmreich RL , Wilhelm JA , Gregorich SE , Chidester TR . Preliminary results from the evaluation of cockpit resource management training (performance ratings of flightcrews) . Aviat Space Environ Med . 1990;61:576–579
  28. Lu H , While AE , Barriball KL . Job satisfaction among nurses (a literature review) . Int J Nurs Stud . 2005;42:211–227

 Competing Interests Declared: None.Supported by the Agency for Healthcare Research and Quality, grant numbers 1UC1HS014246 and 1PO1HS1154401.

PII: S1072-7515(06)00117-7

doi: 10.1016/j.jamcollsurg.2006.01.017

Journal of the American College of Surgeons
Volume 202, Issue 5 , Pages 746-752 , May 2006