Human factors
require close collaboration between multiple team members. A team that is stressed, overworked and overwhelmed is more likely to make a mistake or miscommunicate, which can result in adverse outcomes for patients. Following this, team members can doubt their skills or abilities to continue working in operating theatres, or continue working at all in the NHS, especially if the mistake involves investigation or a court case. Secondly, the welfare and wellbeing of the
operating theatre team can impact patient satisfaction during the hospital journey. A team that is burnt out or struggling with morale issues, or communication barriers and cultural differences may not be able to provide the high level of care that is expected from managers or patients, which can lead to dissatisfaction and negative feedback.13 Patients want to feel that they are receiving the best care, and this includes feeling that their care team is professional, skilled, caring, and happy. Finally, the welfare and wellbeing of operating theatre teams can impact the wider healthcare system and lead to a shortage of staff. Burnout and turnover can impact the quality of care provided across the whole system. Additionally, the costs of recruiting and training new staff to replace, sometimes very experienced and well-trained members of the workforce, can significantly impact the finances of the organisation.
Debriefing as a tool for maintaining wellbeing One tool that was introduced with the WHO surgical checklist was the debrief. The debrief continuously supports the operating theatre staff to make sure that patient surgical intervention was directed correctly and with no harm. However, the full debriefing process should involve reflection and small discussions about improvements and job satisfaction, during an effective and efficient working day,
The wellbeing of operating theatre teams is critical to the success of the surgical intervention and the satisfaction of patients, as well as to the overall health of the healthcare system. Discussing the welfare and wellbeing of the operating theatre team should be as important as patient safety.
as a team. This part of the debrief seems to be forgotten and very rarely takes place in operating theatres. The operating theatre team should have time to communicate any issues or challenges that arose and identify improvements. Debriefing can be a powerful tool for maintaining the welfare of the operating theatre team for a few reasons. Firstly, it provides a space for the team to
reflect on their experiences and emotions, as surgery can be stressful, fearful and unpredictable. The team members may need to process their feelings, in order to maintain their mental health and wellbeing. For example, debriefing can provide a supportive and safe environment to process a patient death or cardiac arrest during the procedure. In this safe environment, being listened to, and sharing emotions or even tears, can build the morale of the team and improve communication in the team itself. By discussing the issues openly and honestly, the team can identify solutions or strategies for improvement in the future. By creating a space for open communication, debriefing can help to build trust and mutual respect, and improve teamwork and collaboration. Therefore, this can improve the quality of care not only for a patient but for each other, reduce the risk of adverse outcomes, and improve the efficiency and effectiveness of the operating theatre team.
Overwhelmed theatre teams: the impact on patient care Ensuring the safety of patients in operating theatres is of paramount importance and a key responsibility of the healthcare team involved in the surgical procedure. Moreover, when the operating theatre team is overwhelmed or overworked, or when there are staff shortages, the risk of adverse events and patient harm can increase. Patient safety is always a priority but so
too is the safety and welfare of the operating theatre team. There are challenges posed by an overwhelmed and overworked operating theatre team. The impact of staff shortages on patient safety can be prevented by planning and implementing strategies for operating theatre staff. Identifying the challenges can be crucial for this planning. These include: Fatigue: Long working hours, long and multiple surgeries in a day, and inadequate rest breaks can lead to fatigue among operating theatre staff. This can influence their cognitive and physical abilities, making them more prone to errors and accidents. Communication breakdown: An operating
theatre team is a multicultural team and, when overwhelmed and overworked, may experience breakdowns in communication, which can result in misunderstanding. That can lead to mistakes or near misses, errors or even never events. Those errors can involve the administration of medication, anaesthesia or wrong procedure.14 Delayed response to emergency: An
overwhelmed and overworked operating theatre team may not be able to respond quickly to an emergency or a critical situation due to a lack of resources or staff abilities or even limitations in equipment stock. This can delay life-saving interventions, or the detection of the risk or complication. Delayed reactions can be fatal for patients or cause harm, or life-changing injury. Shortages of staff on patient safety:
Staff shortages have a significant impact on patient safety. There has been a high demand for surgical procedures after the pandemic, from the Government, the public, surgeons, and theatre management. That brings a
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www.clinicalservicesjournal.com I September 2023
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