Key result
Protocol interventions emerge as highly actionable for operating room teamwork across 249 reviewed studies.
Why the study?
Suboptimal operating room teamwork contributes to preventable complications, but current teamwork interventions have yet to be synthesized by specifying behaviour using actionable frameworks.
Protocol interventions with clear behavioral specifications, such as communication and distraction protocols, are the most actionable teamwork strategies for the operating room.
Supports prioritizing protocol interventions in the OR; extends AACTT framework application to teamwork strategies.
Suboptimal teamwork in the operating room (OR) is a contributing factor in a significant proportion of preventable complications for surgical patients. Specifying behaviour is fundamental to closing evidence-practice gaps in healthcare. Current teamwork interventions, however, have yet to be synthesized in this way. This scoping review aimed to identify actionable strategies for use during surgery by mapping the existing literature according to the Action, Actor, Context, Target, Time (AACTT) framework. The databases MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Cochrane, Scopus, and PsycINFO were searched from inception to April 5, 2022. Screening and data extraction were conducted in duplicate by pairs of independent reviewers. The search identified 9,289 references after the removal of duplicates. Across 249 studies deemed eligible for inclusion, eight types of teamwork interventions could be mapped according to the AACTT framework: bundle/checklists, protocols, audit and feedback, clinical practice guidelines, environmental change, cognitive aid, education, and other), yet many were ambiguous regarding the actors and actions involved. The 101 included protocol interventions appeared to be among the most actionable for the OR based on the clear specification of ACCTT elements, and their effectiveness should be evaluated and compared in future work.
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Ghanmi et al. (2024) conducted a review in Suboptimal teamwork in the operating room (n=249). Actionable teamwork strategies (AACTT framework) was evaluated on Mapping of teamwork interventions according to the Action, Actor, Context, Target, Time (AACTT) framework. Across 249 studies, eight types of teamwork interventions were mapped according to the AACTT framework, with protocol interventions appearing to be among the most actionable for the operating room.
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