Improving teamwork and communication to further the patient safety culture

The Commission is continuing its focus on reducing patient harm during the perioperative period by encouraging improved teamwork and communication across the operating theatre team. Our work programme is based on international experience of introducing briefing, the surgical safety checklist, and debriefing as tools to change the culture within the operating theatre.

The programme is supported by strong clinical leadership from both surgical and nursing perspectives and an expert advisory group is in place. Based on the advice of the advisory group we are actively testing the application of a range of international interventions and approaches with both public and private hospital surgical teams using a ‘proof of concept’ (PoC) approach.

Theatre teams at Waikato DHB, Lakes DHB and Southern Cross Auckland are participating in the PoC process. The PoC involves three stages: development, deployment and measurement. A multidisciplinary working group has designed and is leading the education programme and deployment of the three clinical interventions – briefing, use of the surgical safety checklist and debriefings.

The working group has also designed a behavioural ‘toolkit’, improvement methodology, and revised measures for the PoC – with a focus on developing a pragmatic and easy to use set of tools.

The PoC approach has been adopted to ensure that a clear, proven process was in place, and is consistent with accepted improvement methodologies. The PoC methodology has also allowed a flexible approach to adapting and selecting interventions based on international evidence and expert advice tailored to the New Zealand context.

The recommendations and outcomes from the proof of concept will be available from October this year and will provide a practical evidence base for further implementation.