Perceptions of Use of Names, Recognition of Roles, and Teamwork After Labeling Surgical Caps

Author:

Wong Becky J.1,Nassar Aussama K.2,Earley Michelle3,Chen Ling4,Roman-Micek Teresa4,Wald Samuel H.1,Shanafelt Tait D.5,Goldhaber-Fiebert Sara N.1

Affiliation:

1. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California

2. Department of Surgery, Stanford University School of Medicine, Stanford, California

3. Department of Surgery, Division of General Surgery, Stanford School of Medicine, Stanford, California

4. Interventional Platform Education, Stanford, California

5. Division of Hematology, Department of Medicine, Stanford School of Medicine, Stanford, California

Abstract

ImportanceCommunication failures in perioperative areas are common and have negative outcomes for both patients and clinicians. Names and roles of teammates are difficult to remember or discern contributing to suboptimal communication, yet the utility of labeled surgical caps with names and roles for enhancing perceived teamwork and connection is not well studied.ObjectiveTo evaluate the use of labeled surgical caps in name use and role recognition, as well as teamwork and connection, among interprofessional perioperative teammates.Design, Setting, and ParticipantsIn this quality improvement study, caps labeled with names and roles were distributed to 967 interprofessional perioperative clinicians, along with preimplementation and 6-month postimplementation surveys. Conducted between July 8, 2021, and June 25, 2022, at a single large, academic, quaternary health care center in the US, the study comprised surgeons, anesthesiologists, trainees, and all interprofessional hospital staff who work in adult general surgery perioperative areas.InterventionLabeled surgical caps were offered cost-free, although not mandatory, to each interested clinician.Main Outcome and MeasureQuantitative survey of self-reported frequency for name use and role recognition as well as postimplementation sense of teamwork and connection. The surveys also elicited free response comments.ResultsOf the 1483 eligible perioperative clinicians, 967 (65%; 387 physicians and 580 nonphysician staff; 58% female) completed preimplementation surveys and received labeled caps, and 243 of these individuals (51% of physicians and 8% of staff) completed postimplementation surveys. Pre-post results were limited to physicians, due to the low postsurvey staff response rate. The odds of participants reporting that they were often called by their name increased after receiving a labeled cap (adjusted odds ratio [AOR], 13.37; 95% CI, 8.18-21.86). On postsurveys, participants reported that caps with names and roles substantially improved teamwork (80%) and connection (79%) with teammates. Participants who reported an increased frequency of being called by their name had higher odds for reporting improved teamwork (AOR, 3.46; 95% CI, 1.91-6.26) and connection with teammates (AOR, 3.21; 95% CI, 1.76-5.84). Free response comments supported the quantitative data that labeled caps facilitated knowing teammates’ names and roles and fostered a climate of wellness, teamwork, inclusion, and patient safety.Conclusions and RelevanceThe findings of this quality improvement study performed with interprofessional teammates suggest that organizationally sponsored labeled surgical caps was associated with improved teamwork, indicated by increased name use and role recognition in perioperative areas.

Publisher

American Medical Association (AMA)

Subject

General Medicine

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