Creating a Culture of Open Communication in a Hospital OR

Success in the operating room depends on the coordination of multiple people and processes. Defining who the OR team is comprised of and being able to communicate with this team can facilitate this coordination and ultimately improve patient safety, quality of care and patient, employee and physician satisfaction. Jay Rindenau, MD, coordinator of clinical affairs at St. Vincent's Medical Center in Los Angeles, explains how he creates a culture in the OR where every member of the team is comfortable communicating with each other.

In addition to who is traditionally considered part of the OR team — surgeons, nurses and anesthesiologists — other employees who play a part in OR processes should be included, Dr. Rindenau says. For example, he says a phlebotomist needs to know what blood tests are marked for the OR so the blood results get to the OR on time and there are no delays in surgery. Transporters, as well, are stakeholders in the OR because they can affect its efficiency. If they miss an elevator, for instance, that could delay a start time by 15 minutes, Dr. Rindenau says. "Phlebotomists, transporters, people who clean the rooms — everybody is considered a stakeholder and team member, is given the same respect as anybody else and expected to perform," he says.

All members of the team need to communicate with each other to streamline workflows and improve efficiency. "People need to feel comfortable being honest with constructive criticism up the food chain rather than just down the chain," Dr. Rindenau says, referring to the hierarchy within the team. "People [need to] feel very safe coming forward; that's how you learn about problems."

Creating a culture in which all stakeholders are able to communicate honestly with each team member starts with OR leadership, Dr. Rindenau says. Instead of establishing requirements for the team without their participation, the leader should ask the team members for their input. For example, the leader should ask the transporter how much time transportation requires and what delays they encounter on the floors picking up patients. Asking for team members' input increases the likelihood they buy in to any changes the leader makes. "A good leader gets people to do the right thing when nobody is looking," Dr. Rindenau says.

Related Articles on OR Efficiency:

Anesthesia's Role in Improving Departments Touching the OR: Q&A With Dr. John Di Capua of North American Partners in Anesthesia and North Shore-LIJ Health System
Using Mobile Devices in the OR to Speed Processes

Case Study: Improving Hospital Operating Room Efficiency

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