A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center

Arch Surg. 2010 May;145(5):489-95. doi: 10.1001/archsurg.2010.65.


Objective: To create and test a reproducible method for measuring emotional climate, surgical team skills, and threats to patient outcome by conducting an observational study to assess the impact of a surgical team skills and communication improvement intervention on these measurements.

Design: Observational study.

Setting: Operating rooms in a high-volume thoracic surgery center from September 5, 2007, through June 30, 2008.

Participants: Thoracic surgery operating room teams.

Interventions: Two 90-minute team skills training sessions focused on findings from a standardized safety culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication, and leadership. The sessions created an interactive forum to educate team members on the importance of communication and to role-play optimal interactive and communication strategies.

Main outcome measures: Calculated indices of emotional climate, team skills, and threat to patient outcome.

Results: The calculated communication and team skills score improved from the preintervention to postintervention periods, but the improvement extinguished during the 3 months after the intervention (P < .001). The calculated threat-to-outcome score improved following the team training intervention and remained statistically improved 3 months later (P < .001).

Conclusions: Using a new method for measuring emotional climate, teamwork, and threats to patient outcome, we were able to determine that a teamwork training intervention can improve a calculated score of team skills and communication and decrease a calculated score of threats to patient outcome. However, the effect is only durable for threats to patient outcome.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Communication*
  • Educational Measurement / methods*
  • Emotions*
  • Female
  • Group Processes
  • Humans
  • Interprofessional Relations*
  • Male
  • Middle Aged
  • Operating Rooms
  • Outcome Assessment, Health Care
  • Patient Care Team / organization & administration*
  • Reproducibility of Results
  • Role Playing
  • Social Environment
  • Thoracic Surgery / education*