Accepted for/Published in: JMIR Human Factors
Date Submitted: Nov 20, 2019
Date Accepted: Feb 14, 2020
Assessing teamwork in complex aortic surgery: a single center experience with the Safety Attitudes Questionnaire as diagnostic tool.
ABSTRACT
Background:
Improving teamwork in surgery is a complex goal and difficult to achieve. Human factors questionnaires such as the SAQ can help understand medical teamwork and may aide in this task.
Objective:
To assess local team- and safety culture to understand how purposeful teamwork improvements can be formed.
Methods:
Two vascular surgical teams were assessed; a endovascular treatment team (ETT) and an open treatment team (OTT). Both teams answered an online version of the SAQ-NL consisting of 30 questions related to 6 different domains of safety (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions). In addition, one open question was asked to gain more insight in the completed questionnaires.
Results:
The SAQ-NL was completed by 23 (100%) ETT members and 13 (100%) OTT members. Team buildup was comparable for both (60% males and 50% physicians). All participants worked ≥10 years in healthcare. Total team tenure for the ETT was higher than for the OTT (55% vs 23% of members working in the team for ≥5 years). SAQ-NL mean scores were comparable between both teams, important differences were found between the physicians and support personnel of the ETT. Support personnel was less positive about the safety climate, job satisfaction and working climate domains than physicians (p<.05). Additional education on performed procedures, more conjoined team training as well as a hybrid OR were suggested by participants as important areas of improvement.
Conclusions:
Support personnel of a local team performing endovascular aortic aneurysm surgery perceive safety climate, job satisfaction and working conditions less positive than physicians in the same team. Open ended questions specified this to be related to lack of adequate conjoined training, education and a sufficient operating room. With this addition, the SAQ-NL appears to be an assessment tool which allows developing strategies that are instrumental in improving quality of care.
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