Article report on how communication disruption causes waste during surgeries.

(Title:) Communication Failures in the Operating room: an Observation Classification of  Recurrent Types and Effects.

(Authers:) L Lingard, S Espin, S Whyte, G Regehr, G R Baker, R Reznick, J Bohnen, B Orser, D Doran, E Grober.

(Source:) Quality Safe Health Care 2004; 13:330-334.

Disruptions come in many forms. In teams a prominent cast of disruption is miss communication. A stable dialog between team members creates efficient flow of information that promotes shared goals and coordinated action among the team members.  Shared goals and action make the team more efficient. A communication disruption can quickly derail a team’s ability to identify and share goals and actions. L. Lingard and ect., article talk about the types of communication disruption, how often they occur and their effects on surgical teams.

This article draws data from the observation of 48 surgical procedures.  Reviewing those observation revealed four types of communication disruptions or failures. These communication failures occurred in 30% of surgical procedure. The researchers also determined which type of disruption had the most visible effect on the surgical procedure. 36.4% of communication failure had visible negative effects on the surgical procedures efficiency and team members.

A communication disruption can have seven negative effects; they are as follows. Inefficiency is redoing a part of the procedure, thus wasting time and effort. Tension is emotional distress between team members that can lead to lowered ability to work efficiently with each other. Delay is the slowing down of the procedure.  Workaround is the team deviating from the standard procedure, this can endanger the patient.  Resource waste is using too many supplies to finish the procedure. Patient inconvenience is using up more patients time then required and putting the patients through more suffering. Procedural error is making a mistake during the procedure. All types of communication disruption cause these negative affects.

The most common and disruptive of the communication disruption is ‘Occasion failure’, which is a failure to make a communication at the right time. ‘Occasion failure’ mostly results in inefficiency, tension between team members, and delay off key parts of the surgical procedure.

‘Content failure’ is the second most common and least disruptive of communication disruption. ‘Content failure’ is miss communicated information between team members. It is liable to cause all the negative effects.

The third most common and second most disruptive of the communication disruptions is ‘Purpose failure’, which is a failure of the leader of the team to communicate a clear goal to the rest of the team. ‘Purpose failure’ mostly results in inefficiency and tension.

‘Audience failure’ is the least common and third most disruptive of the communication disruption. ‘Audience failure’ is team members’ failure to listen and understand each other. It is liable to cause all the negative effects.

36.4% of communication failures endanger the patient by causing disruptions. The causes of these disruptions should be addresses, because they result and will continue to result in human death and suffering.