Anne van Dalen

Improving teamwork and communication in the operating room I 179 6 DISCUSSION During the pilot study MDR debriefings, participants realised how difficult it apparently is to remember each other’s names. Moreover, participants indicated they felt ashamed or awkward for not knowing the names of their colleagues, with whom they had worked multiple times before. The importance of awareness and education in communication skills in a high-risk environment such as the OT may hence not be underestimated (Catchpole and Russ 2015, Rydenfalt et al 2013). Davis et al (2017) demonstrated directed communication was associated with an increased likelihood of receiving a proper answer and confirmation that the message was received. Increased incidence of check backs (ie as part of the CLC technique) reduced the number of ineffective communication events, provided opportunities for clarification of safety-critical information, and enhanced the OT team’s shared mental model. They also emphasised that addressing each other by name before sending the message may avoid unnecessary miscommunication. Perhaps not surprisingly in daily practice with many checklists to complete, the name introduction item was usually ‘checked off’ by the team, without actually officially have taken place. Team members may say that they had worked with the same team members before; ‘We know each other already’. Yet, 59% of the time, the staff could not recall all the names of the team members whom they had performed the surgical procedure with. Non-compliance with this step of the SSC has been demonstrated in other studies (Levy et al 2012, Rydenfalt et al 2013) and once again highlights the problem with checklists. Just ‘checking the box’, by having it secured in the patient file does not mean the check has actually been performed, questioning its true value (Catchpole and Russ 2015, Rydenfalt et al 2013). Usually, OT staff uses the team brief and the time-out as part of the five steps to safer surgery, before the start of the surgical procedure to introduce their name and role (Russ et al 2015). This may be helpful, but not suffice to adequately remember all the names. In certain situations or phases of a procedure, with staff fully focusing on important tasks, it is notably difficult to recall names, because faces are behind surgical caps and masks. Especially now during the COVID-19 pandemic, protective clothing and respiratory masks make it even more difficult to recognise each other in the hospital.