Operating theatres
Tackling hierarchies and waste in theatres
The team brief is an important part of effective team working in theatres. An innovative but simple initiative to ensuring everyone feels part of the team is simultaneously tackling environmental and infection control issues in theatres. Danielle Checketts provides an insight.
The NHS is striving to be more sustainable, moving to greener alternative products, away from disposable items where the daily contribution results in millions of single-use throw-away items going to landfills. The Royal College of Surgeons has recognised that it is imperative to act collectively and urgently to address this issue, so they have developed a Green Theatre Checklist to help drive greener changes. Reusable textiles advice, from this checklist, includes switching to reusable theatre hats, sterile gowns, patient drapes, and trolley covers. A recent innovation in this area has been
developed, which follows the sustainable changes, but can also help to flatten hierarchies, improve teamwork, reduce the risk of infection and create efficiencies, ultimately having positive impacts on patient safety and care quality.
Communication in surgery The UK healthcare system operates within a stringent framework designed to ensure high-quality patient care. However, beneath this structure lies a complex network of hierarchical barriers that can impede effective communication, collaboration and, ultimately, patient outcomes. These barriers arise from various sources, such as professional hierarchies with differing levels of authority within healthcare teams. In operating theatres, confusion often surrounds the names and roles of team members, leading to communication breakdowns.
An initiative is helping to address these concerns by identifying every individual involved in the operating theatre team, ensuring clear recognition of roles. Additionally, this initiative has the potential to promote sustainable practices, aligning with efforts to reduce waste and improve environmental efficiency within healthcare settings. By tackling both communication and environmental challenges, this approach offers a comprehensive improvement to the operating theatre experience for both staff and patients.
In one survey, two-thirds of nurses and
physicians cited better communication in a team as the most important element in improving safety and efficiency in the operating room.1
formal introductions, which are to be made in the morning before surgery commences, to address these problems.2
However, many
members of staff forget, shortly after these introductions are made, who their co-workers are. As one Consultant Anaesthetist commented, “The team huddle is all well and good in the morning, but I don’t remember everyone’s names and if we had named caps for everyone that would be great.”3
Identification in theatres The operating theatre is a setting where patient harm and medical errors continue to happen, many of which are preventable.4
Everyone looks
the same in theatres and typically wear the same colour scrubs and disposable caps. Name
The WHO developed a checklist to include
badges are frequently covered by surgical attire and are difficult to read from afar. Lanyards are sometimes worn but are banned in many theatres, due to their infection risk, and often turn and twist around, which makes trying to read the names challenging and awkward. Recent studies point out that using the time just before skin incision to review the names and roles of all team members is a vital requirement and forms part of the surgical safety checklist,5 which was designed to reduce surgical complications and improve communication and teamwork in the operating theatre.6 As a regular visitor to operating theatres in
various hospitals in the UK, I rarely knew the names of the other people in the room and sometimes I assumed that the people I was standing beside were clinicians, when often they were students or representatives from companies. New starters would rarely know anyone in the room, and they struggled to remember the names and roles of the staff –
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