Our Shared Purpose: Teamwork.

Abstract

This year, National Time Out Day is recognized June 10. Time outs for operative and other invasive procedures help to prevent the occurrence of errors related to wrong-site, wrong-procedure, or wrong-person surgery. The implementation of the Universal Protocol and the attention of the World Health Organization to the contributing factors surrounding these errors have assisted perioperative teams in addressing these concerns more systematically. Checklists and protocols have been useful in helping teams to focus on reducing the incidence of errors; however, the characteristics of teams and how well they function also play a role in safety. Industries such as the airlines and the military have made significant efforts to understand the dynamics associated with teams and needed training to support safety.1 In addition, health care researchers continue to explore implications of how teams and teamwork affect patient safety.2, 3 In one study, researchers examined how team training affected patient outcomes and found strong relationships between improved reports of teamwork, team communication, and application of best practices (eg, prophylactic antibiotic administration, venous thromboembolism prophylaxis) as well as important outcome measures (eg, surgical mortality, morbidity).3 Tools such as TeamSTEPPS, developed to train teams on important concepts related to communication and safety protocols, have proven to be very useful in promotion of optimal teamwork behaviors.4, 5 In the perioperative setting, some organizations have taken the steps to train interdisciplinary teams in using these methods. Understanding the effectiveness of the use of these tools over time has become a significant interest for researchers focused on health care safety and efficiency. Researchers found positive reports of effective communication among team members when standardized tools such as TeamSTEPPS or other crew resource management tools were used.6, 7 However, tools that improve how teams work together are only one aspect of this discussion. Another component is better understanding the characteristics of the team itself. Are there strategies for team construction and for how to best support teams that can help promote safer care and improve patient outcomes? These are only some of the questions for researchers to explore regarding health care teams and their effect on safety and efficiency. The perioperative setting is a prime location for these questions to be studied. Perioperative nurses are keenly aware of how team dynamics affect safety and patient outcomes, and they are in an optimal position to assist with or conduct research to help the health care community better understand teams and teamwork. Many perioperative nurses believe that when team members are familiar with each other, the team produces better outcomes and provides safer care. This is an area of significant opportunity for researchers to conduct important and impactful study to explore this belief further. Other characteristics of interest include individual- and team-level experience, as well as the effects of specialty training for the team and individual team members on patient outcomes. For many years, AORN has supported an interdisciplinary team approach to providing care in the perioperative setting. Our Association has been a key member of the Council on Surgical and Perioperative Safety, an interdisciplinary group of membership associations representing the professionals that work in and around the surgical and perioperative settings. This council recognizes that care of patients in the perioperative setting requires a highly diverse and extensively trained team of professionals—not simply a group of individuals. In addition, the AORN Position Statement on Preventing Wrong-Patient, Wrong-Site, Wrong-Procedure Events8 states clearly that interventions to prevent these errors are multidisciplinary and require health care professionals to communicate and work together to provide a safe environment for patients. National Time Out Day provides an opportunity for nurses to emphasize the role they play in advocating for patients, which must be valued and reinforced at every opportunity. This also is a time for all team members to focus on and commit to the time out as a fundamental component of perioperative safety and to recognize how the perioperative team as a whole supports patient safety. To learn more about Time Out Day, you can access information and resources at https://www.aorn.org/event​s/natio​nal-time-out-day. Editor's notes: The Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery is a trademark of The Joint Commission, Oakbrook Terrace, IL. TeamSTEPPS is a registered trademark of the Agency for Healthcare Research and Quality, Rockville, MD. David Wyatt, PhD, RN, CNOR, NEA-BC, is the AORN President and Chief Nursing Officer of University Hospitals at the University of Texas Southwestern Medical Center, Dallas. Dr Wyatt has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.