Anne van Dalen

Improving teamwork and communication in the operating room I 173 6 INTRODUCTION The importance of clear communication in the operating theatre (OT) has been widely recognised (Espin et al 2020). Yet, ineffective communication is a major root cause of surgical adverse outcomes (Leonard et al 2004, Wahr et al 2013). The crew resource management principles, adapted from the aviation industry, emphasise the importance of using the closedloop communication (CLC) technique in preventing adverse events (El-Shafy et al 2018). CLC includes three components: (1) an initial message that starts with stating the name of the recipient, known as directed call out, (2) verification by the named recipient, including repeating the critical aspect of the message, known as check back and (3) verification by the message sender that the recipient has interpreted the sent message correctly, known as closing the loop (Davis et al 2017, El-Shafy et al 2018). Accordingly, the World Health Organization (WHO) Surgical Safety Checklist (SSC) briefing includes an introduction stating name and role of all team members before start of a procedure. However, there is little data to support how name and role introductions improve name recall amongst staff (Birnbach et al 2017, Burton et al 2018). Simple strategies to remember and use each other’s names and roles, besides the SSC introduction round, writing down the names on a whiteboard, and briefing exist. In addition, the Patient Safety Network’s ‘Theatre Cap Challenge’ emphasises the importance of visible staff identification, by putting your name and role on your surgical cap when working in highly stressful environments such as the OT (Burton et al 2018). Some departments, such as the trauma room, already used name stickers to identify the staff, so this method may be easily rolled out in the OT (El-Shafy et al 2018). During the roll out of the use of the theatre cap challenge, the aims of this study were to (1) evaluate if name and role instructions as part of the WHO’s SSC were actually completed, (2) how well team members were able to remember and recall each other’s name and (3) evaluate the introduction of the theatre cap challenge at our medical centre.