Analyzing Communication Patterns of Surgical Team Members Based on the Surgical Safety Checklist in the Operation Room: The Case of 2018

Background: One of the most fundamental causes of medical errors is the lack of proper communication between the members of the treatment team. The World Health Organization (WHO) has introduced the surgical safety checklist (SSC) for surgical safety to provide a safe environment for patients undergoing surgery, improve communication between surgical team members, and prevent potential medical errors. Objectives: This study evaluated the communication patterns of surgical teams in order to examine the ways to implement various guidelines of the SSC. Methods: In this descriptive cross-sectional study, a trained researcher attended 48 operations from late September to late November 2018. The observer recorded qualitatively the communication behaviors of the surgical team in implementing various items of the SSC. The observations were subsequently examined in two general categories of verbal and non-verbal communications. The surgical procedures were observed at three stages: patient’s admission until entry to the operating room, entry to the operating room until anesthesia induction, and anesthesia induction until patient’s transfer from the operating room. Results: In this study, 31 individuals took part in 48 different surgical teams. Observing the communication patterns revealed the lower frequency of verbal communication (13.27%) than that of non-verbal communication (32.12%). The most frequent failure in verbal communication occurred at the anesthesia induction stage (48.57%) and it was related to operating room equipment (6 out of 35 cases of failure). By contrast, the least frequent failure in verbal communication was associated with patient’s admission until entry to the operating room (17.14%). Conclusions: Various cases of communication failure were seen among surgical team members. It is proposed that appropriate training programs be devised to establish a successful communication environment for the correct use of SSC and further clarification of communication patterns in surgical procedures.