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  • Building shared situational awareness in surgery through distributed dialog

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    88990_1.pdf (204.0Kb)
    Author(s)
    Gillespie, BM
    Gwinner, K
    Fairweather, N
    Chaboyer, W
    Griffith University Author(s)
    Chaboyer, Wendy
    Gillespie, Brigid M.
    Gwinner, Karleen
    Year published
    2013
    Metadata
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    Abstract
    BACKGROUND: Failure to convey time-critical information to team members during surgery diminishes members' perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness. METHODS: Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semistructured interviews ...
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    BACKGROUND: Failure to convey time-critical information to team members during surgery diminishes members' perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness. METHODS: Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semistructured interviews were performed with 24 participants from anesthesia, surgery, and nursing in the operating rooms of a large metropolitan hospital in Queensland, Australia. Thematic analysis was used. RESULTS: The domain "coordinating decisions in surgery" was generated from textual data. Within this domain, three themes illustrated the dialog of clinical decisions, ie, synchronizing and strategizing actions, sharing local knowledge, and planning contingency decisions based on priority. CONCLUSION: Strategies used to convey decisions that enhanced shared situational awareness included the use of "self-talk", closed-loop communications, and "overhearing" conversations that occurred at the operating table. Behaviors that compromised a team's shared situational awareness included tunneling and fixating on one aspect of the situation.
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    Journal Title
    Journal of Multidisciplinary Healthcare.
    Volume
    20
    Issue
    6
    DOI
    https://doi.org/10.2147/JMDH.S40710
    Copyright Statement
    © 2013 Gillespie et al, publisher and licencee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. Please refer to the journal's website for access to the definitive, published version.
    Subject
    Clinical Nursing: Secondary (Acute Care)
    Medical and Health Sciences
    Publication URI
    http://hdl.handle.net/10072/58155
    Collection
    • Journal articles

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