2024, Number 2
Psychological safety in the operating room
Full text
10.35366/118275
Language: English/Spanish [Versi?n en espa?ol]
References: 2
Page: 85-86
PDF size: 197.96 Kb.
Leaders must remember that an emotionally intelligent group does not necessarily result in an emotionally intelligent group. Vanessa Urch mentions that team members must feel that they work better together than individually, so leadership must generate trust and a true sense of group identity, and rules must be established that favor awareness and management of emotions within and outside the team.1
Understanding psychology within the OR is important, mainly because of the emotional burden and stress experienced within the OR; psychological knowledge can significantly improve the quality of communication. OR leaders should always consider hiring personnel with psychological knowledge to contribute to the success of the group or team.1
Interpersonal difficulties are common in the operating room. However, if anyone has the skills, he/she can achieve respect and success by communicating effectively and overcoming the situation's problems.1
If questions are not allowed inside the operating room, reporting errors or making any observations, receiving only criticism can make the environment more stressful and harm the functioning of the operating room and the patient.2
These situations are the basis of why the operating room environment must be psychologically safe; this safe working environment in which open communication between the entire team provides quality patient care and reduces stress.2
When psychological safety is combined with discipline and shared responsibility, better outcomes, problem-solving, a learning environment, adaptability, and psychological health for the entire surgical team can be achieved.
Dr. Harry T. Papaconstantinou, a coloproctologic surgeon, states that it is best to have a safe psychological environment; it is okay to take risks, express ideas or concerns, admit mistakes, and ask questions, all without negative consequences. One must have the ability to speak up without being judged.2 If the entire operating room staff feels empowered to point out a possible error, the result will be a decrease in these errors, and they may even be corrected so that they do not happen again.2
Dr. Edmondson says that psychological safety means not hesitating at all if a team member has a remote suspicion that the surgeon is about to do something wrong; the psychologically safe environment fosters openness, and openness requires courage and honesty.2 She mentions that work is more engaging and meaningful if it is believed that matters and the voice is expected and welcome.
Team members who interrupt a surgery with out-of-place, irrelevant, and unhelpful comments should be spoken to and, if necessary, removed from the operating room.2
A psychologically safe operating room is a learning environment where there should be mutual professional respect, open communication, and no judgment. Operating room teams that demonstrate higher levels of psychological safety can implement new technologies.2
Psychological safety supports these conditions that contribute to making work meaningful and engaging:2
- 1. Purpose and significance
- 2. Culture and community
- 3. Growth and development
If no one listens, and the input is not well received, working in harmony will be lost.
Dr. Edmondson says that if someone is in surgery and is not in learning mode, the job will not be doing as well as it should be.
A psychologically safe environment relieves the surgeon of some of his or her burden; it has been shown that mistakes can be made when the surgeon does not feel secure and does not have his or her team. Surgeons can help create a psychologically safe environment because they are the leaders in the operating room and can ask their team for suggestions and feedback.2
Self-awareness is fundamental in surgeons; they must know how they are perceived to model the desired behavior.
Dr. Papaconstantinuou states that how the surgeon poses questions and responds determines whether team members can ask questions. The surgeon should be prepared to handle emotions in the operating room.
What should the surgeon do to create psychological safety?
Set the stage: the surgeon should tell the team that they are not infallible and that if they see a mistake being made, they should give notice and be humble.
Seek feedback: ask questions and involve the team.
Respond appropriately: do not make gestures if someone does not agree with an answer, thank contributions in a positive way, and control when comments are not helpful.
Dr. Papaconstantinou states that trust helps create an environment of mutual professional respect essential for psychological safety.
Working with the same team is better. Staff rotation should be avoided; the team must be consistent.
Changing the culture of psychological safety within the operating room requires attacking from several points. Surgeons and other managers must learn more about this concept and include it in the education and training programs of residents and staff involved in the operating room.
Creating a safe environment will lead to better outcomes and is fundamental to patient safety.
REFERENCES
McCartney J. Psychological safety in the OR improves outcomes and performance. Bulletin ACS. 2024; 109 (5). Available in: https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2024/may-2024-volume-109-issue-5/psychological-safety-in-the-or-improves-outcomes-and-performance/
AFFILIATIONS
1 Mexican School of Medicine of La Salle University, Mexico.
2 Editor-in-Chief. Assistant Physician, General Surgery, Hospital General Tacuba ISSSTE. ORCID: 0000-0001-5635-5845
3 Head of the Center for Educational Innovation in Medicine and Clinical Simulation at La Salle. ORCID: 0000-0002-0451-5285
CORRESPONDENCE
Dr. Abilene Cirenia Escamilla-Ortiz. E-mail: escamillaoa@amcg.org.mx