597 Incivility in the Operating Theatre

Abstract

Abstract Aim To establish the prevalence of incivility within operating theatres, understand its impact on wellbeing, team performance, training, and direct future studies. Method A systematic search was conducted using keywords for incivility in healthcare. Studies reporting incivility from all operating theatre MDT members were included. Data extraction was designed to establish prevalence of incivility, compare experiences in different specialties, assess the potential impact on performance and wellbeing and establish questions for inclusion in a national cross-sectional study. Results Incivility can be defined as ‘un-civil behaviour, characteristically rude and discourteous, displaying a lack of regard for others.’ 62 papers discussing incivility, bullying and harassment within healthcare settings were identified. 14 focused specifically on incivility in surgical teams. 48-98% of healthcare staff reported experiencing incivility, with surgeons being the most likely perpetrators. It was more commonly experienced by female, non-heterosexual, and inexperienced members of staff, including trainees. Incivility was associated with reduced performance, higher complication rates, workplace withdrawal, reduced organisational commitment, productivity, and wellbeing. Reduction strategies largely focused on education surround incivility, which appears to have minimal impact. Conclusions Incivility has only recently been discussed within a healthcare setting. Its consequences can have a significant impact on teams, and it warrants attention to improve performance, wellbeing and retention. Surgical theatres offer unique challenges from a teamwork perspective and should therefore be studied at an MDT level. These results have informed the design of a national, cross-sectional mixed methods study of incivility in the operating theatre MDT, which will be conducted throughout 2023.