Quality of Communication in Robotic Surgery and Surgical Outcomes
Schiff L, Tsafrir Z, Aoun J, Taylor A, Theoharis E, and Eisenstein D. Quality of communication in robotic surgery and surgical outcomes. Jsls 2016; 20(3)
JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
BACKGROUND AND OBJECTIVES: Robotic surgery has introduced unique challenges to surgical workflow. The association between quality of communication in robotic-assisted laparoscopic surgery and surgical outcomes was evaluated.
METHODS: After each gynecologic robotic surgery, the team members involved in the surgery completed a survey regarding the quality of communication. A composite quality-of-communication score was developed using principal component analysis. A higher composite quality-of-communication score signified poor communication. Objective parameters, such as operative time and estimated blood loss (EBL), were gathered from the patient's medical record and correlated with the composite quality-of-communication scores.
RESULTS: Forty robotic cases from March through May 2013 were included. Thirty-two participants including surgeons, circulating nurses, and surgical technicians participated in the study. A higher composite quality-of-communication score was associated with greater EBL (P = .010) and longer operative time (P = .045), after adjustment for body mass index, prior major abdominal surgery, and uterine weight. Specifically, for every 1-SD increase in the perceived lack of communication, there was an additional 51 mL EBL and a 31-min increase in operative time. The most common reasons reported for poor communication in the operating room were noise level (28/36, 78%) and console-to-bedside communication problems (23/36, 64%).
CONCLUSION: Our study demonstrates a significant association between poor intraoperative team communication and worse surgical outcomes in robotic gynecologic surgery. Employing strategies to decrease extraneous room noise, improve console-to-bedside communication and team training may have a positive impact on communication and related surgical outcomes.
Medical Subject Headings
Adult; Blood Loss, Surgical; Communication; Gynecologic Surgical Procedures; Humans; Interprofessional Relations; Middle Aged; Operative Time; Patient Care Team; Pilot Projects; Postoperative Complications; Principal Component Analysis; Prospective Studies; Quality Assurance, Health Care; Quality Indicators, Health Care; Robotic Surgical Procedures