Tribalism in the workplace: Anesthesia providers and others differing perceptions on causes of scheduling delay

Abstract

PurposeOperating an interventional radiology (IR) service takes the cooperation of a team of physicians, advanced practice providers, nurses, technologists, and anesthesia providers. Addressing delays in patient flow through IR takes the cooperation of all these groups. To measure the varying perceptions of the causes of these delays, IR team members were surveyed regarding the frequency and duration of potential sources of delay. MethodsA 13-question survey regarding perceived causes of potential delays was sent to all staff employed at a single academic center interventional radiology service. The survey responses were grouped by their role on the team: IR practitioners, technologists, nurses, and anesthesia providers. Intergroup rankings were compared using a Tau test. ResultsThere were 47 respondents out of a potential pool of 73 (64%). Significant differences were found between anesthesia providers and all three other groups regarding the most frequent and lengthy causes of pre-procedure and intra-procedure delays—the three other groups all perceived anesthesia delays as more common and severe (P values of 0.001, 0.001, and 0.009 for LIPs, nurses, and techs, respectively). Similarly, LIPs reported significantly different perceptions of the causes of most frequent delays against all 3 other groups (P values of 0.009, 0.009, and 0.001 for nurses, techs, and CRNAs respectively). Each group tended to rank their contributions to delays as less frequent and lengthy than all other groups, as evidenced by the fact that 8/12 pre-procedure rankings attributable to one group showed evidence of this pattern. ConclusionThis survey, at a single institution, revealed significant differences in opinion about the causes of procedure delays with individual groups tending to blame themselves much less for errors than others. Although not generalizable, these results suggest a source of inter-group stress that may be mitigated with improved communication, changes in education, and training in perspective-taking.