Ivarsson-Aberg2020

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Ivarsson-Aberg2020
BibType ARTICLE
Key Ivarsson-Aberg2020
Author(s) Jonas Ivarsson, Mikaela Åberg
Title Role of requests and communication breakdowns in the coordination of teamwork: a video-based observational study of hybrid operating rooms
Editor(s)
Tag(s) EMCA, Operating rooms, Requests, Surgery, Miscommunication, Repair
Publisher
Year 2020
Language English
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Month
Journal BMJ Open
Volume 10
Number e035194
Pages
URL Link
DOI 10.1136/bmjopen-2019-035194
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
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Chapter

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Abstract

Objectives This study investigated the functional role of ‘requests’ in the coordination of surgical activities in the operating room (OR). A secondary aim was to describe, closely, instances of potential miscommunication to scrutinise how so-called conversational repairs were used to address and prevent mistakes. Design Non-participant video-based observations. Setting Team coordination around image acquisitions (digital subtraction angiography) done during endovascular aortic repair (EVAR) procedures in a hybrid OR. Methods The study followed and documented a total of 72 EVAR procedures, out of which 12 were video-recorded (58 hours). The results were based on 12 teams operating during these recorded surgeries and specifically targeted all sequences involving controlled apnoea. In total, 115 sequences were analysed within the theoretical framework of conversation analysis. Results The results indicated a simple structure of communication that can enable the successful coordination of work between different team members. Central to this analysis was the distinction between immediate requests and pre-requests. The results also showed how conversational repairs became key in establishing joint understanding and, therefore, how they can function as crucial resources in safety management operations. Conclusion The results suggest the possibility of devising an interactional framework to minimise problems with communication, thereby enabling the advancement of patient safety. By making the distinction between different types of requests explicit, certain ambiguities can be mitigated and some misunderstandings avoided. One way to accomplish this practically would be to tie various actions to clearer and more distinct forms of expression.

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