Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

INTRODUCTION: The frequency of adverse events in the operating theatre has been linked to the quality of teamwork and communication. Developing suitable measures of teamwork may play a role in reducing errors in surgery. This study reports on the development and evaluation of a method for measuring operating-theatre teamwork quality. METHODS: The Oxford Non-Technical Skills (NOTECHS) scale was developed from an aviation instrument for assessment of non-technical skills. Consultation with experts and task analysis led to modifications reflecting the complexities of the theatre teamwork, particularly the coexistence of three subteams (surgeons, anaesthetists and nurses). The scale was then evaluated using teams performing laparoscopic cholecystectomy (n = 65) before and after teamwork training. Attitudes to teamwork and surgical error rates were assessed by questionnaire and direct observation methods, and used to assess the reliability and validity of the Oxford NOTECHS scale. RESULTS: The interobserver reliability was excellent in 24 operations independently assessed by two observers (R(wg) = 0.99), confirmed by a third observer in 11 cases (R(wg) = 0.99). Validity was demonstrated through improved scores after teamwork training (t = -3.019, p = 0.005), concurrent with improved attitudes to teamwork after training; inverse correlation between NOTECHS scores and surgical errors (rho = -0.267, p = 0.046); strong inverse correlation between surgical subteam score and surgical errors (rho = -0.412, n = 65, p = 0.001); and strong correlation with teamwork scores from an alternative system (n = 5, r = 0.886, p = 0.046). CONCLUSION: The Oxford NOTECHS scale appears to be a reliable and valid instrument for assessing teamwork in the operating theatre, and is ready for further application.

Original publication

DOI

10.1136/qshc.2007.024760

Type

Journal article

Journal

Qual Saf Health Care

Publication Date

04/2009

Volume

18

Pages

104 - 108

Keywords

Clinical Competence, Humans, Medical Staff, Hospital, Observer Variation, Operating Rooms, Patient Care Team, Reproducibility of Results, Task Performance and Analysis