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Project 1: Communication and Efficiency in the Delivery of Theatre Services (CEDOTS)

Project 1: Communication and Efficiency in the Delivery of Theatre Services (CEDOTS)

This project is a service evaluation.

CEDOTS assessed the compliance with the WHO checklist and factors effecting theatre efficiency. It also examined some aspects of communication in theatre.

The project involved data collection over a 6 week period across 6 acute trusts using a combination of paper forms and bring your own device (BYOD) electronic data capture system.

Description

Data was collected from 392 theatre lists covering 19 different surgical specialities. Formal team briefs were held in 85% of theatre lists. Only 58% of these had all medical members of the team present, with surgical consultants and surgical trainees missing in 11% and 30% of cases respectively, compared with a 5% non-attendance rate for each of their anaesthetic counterparts. 92% of the time however, the anaesthetist felt the team brief had been adequate. Holding a team brief was not associated with a delay (>10min) in the start of a theatre list (32% with team brief vs. 37% without, p=0.47, Chi-squared test). A surgical safety checklist was completed in 96% of theatre lists and the anaesthetist thought it had been done properly in 90% of cases. Introduction by name and role occurred in 58%. Subsequently, consultant anaesthetists and consultant surgeons knew each others’ names in 93% (243/260) of theatre sessions, whereas only 30% (59/197) of trainee anaesthetists and trainee surgeons could name each other. The majority of anaesthetists (85%) found routine introductions useful and 74% would find it helpful to have a whiteboard with names and roles in theatre.

Completion of both a team brief and surgical safety checklist are widely established across our region. However, there is still a mismatch between our perception and the actual quality of these routine safety procedures, shown by inconsistent attendance at team briefs and poor rate of introductions, which form an essential part of the “time out” step in the checklists. Furthermore, trainees’ knowledge of their counterpart trainee colleagues appears to be poor. The aviation industry places strong emphasis on their “first names only” rule, reducing potential barriers to effective communication. In the theatre environment, it is highly desirable to ensure knowledge of each colleague’s name and role, particularly across the large and often complex teams. We therefore advocate the consistent use of whiteboards with all names and roles for all theatre cases.

Presentations

Oral presentations

  • Anaesthetic Research Society Winter Meeting, Royal College of Anaesthetists, 1st October 2013
  • Sheffield CAT Annual Scientific Meeting, BB Medical, 4th October 2013
    • awarded second prize for oral presentation

Poster presentations

  • Sheffield Teaching Hospitals Sharing Good Practice Festival July 2014

Publications

  • Bauchmuller K+, Faulds M+, Rosser J+, Miller D+, Mills GH, Wrench I (+ contributed equally) on behalf of SHARC (South Yorkshire Hospitals Audit and Research Collaboration), Abstracts of the Winter Anaesthetic Research Society Meeting (ARS). British Journal of Anaesthesia (2014) 112 (1): 181

Downloads

Project 1: Data Collection Proforma

  • Paper version of data collection proforma for CEDOTS

Project 1: CEDOTS Presentation

  • CEDOTS presentation given at ARS and CAT ASM Oct 2013

Project 1: CEDOTS Abstract

  • Abstract submitted to ARS Winter Meeting 2013 and published in the BJA Jan 2014

Project 1: Record of Participation

  • This can be placed in portfolios to demonstrate involvement with the project

SHARC Project 1: CEDOTS July 2014

  • Sheffield Teaching Hospitals Sharing Good Practice Festival July 2014

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