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Study: Teamwork makes surgery safer
by Liz Szabo / (c) 2010, USA TODAY International. Distributed by Tribune Media Services International.
Training doctors and nurses to work as teams─using safety techniques borrowed from the aviation industry─cut the death rate from surgery by 18 percent, a new study shows.
Surgical teams in the study, which included 108 hospitals around the country, focused on low-tech techniques, such as holding briefings and debriefings before and after each operation, says study author and former astronaut James Bagian, a professor at the University of Michigan's medical and engineering schools.
These briefings, which are routinely conducted before airplane flights, allow crews to anticipate and prepare for potential safety risks, Bagian says.
Briefings helped surgical teams make important discoveries, such as learning that patients were on blood thinners, which increase the risk for serious bleeding during surgery. "You don't want to be surprised in the middle of surgery," he says.
Researchers trained operating room staff at 74 hospitals. Teams learned to recognize red flags, challenge each when they found safety risks and develop presurgical checklists, according to the study in the Journal of the American Medical Association. The more training surgical teams received, the safer they became, Bagian says.
But Bagian notes his study has limitations. The 34 hospitals that hadn't yet undergone training at the time of the study also improved, reducing their surgical m ortality rate by 7 percent, he says. And the design of his study prevents him from concluding that training actually caused the drop in mortality, although the link seems strong.
But the study is also the largest and most rigorously designed of its kind, says Peter Pronovost, a doctor and safety advocate.
"For decades, surgery and anesthesiology have focused on the technical work," Pronovost says. "But the harm that's occurring [from surgery] is happening due to teamwork failure, not technical failures. This is something every hospital can do."