Health, Australia (Commonwealth Union) – Researchers in Australia have effectively tested an innovative approach to curb offensive and impolite comments within operating theatres. They placed eye-shaped signage on the walls of a surgical room in an Adelaide orthopaedic hospital without providing any explanation. The visual cues, despite being artificial, proved to be influential in significantly reducing inappropriate behavior among surgical teams.
Professor Cheri Ostroff, the lead researcher from the University of South Australia, attributed the success to the perception of being “watched” created by the eye images. The three-month experiment aimed to address a prevalent culture of bullying and misconduct in surgical theatres, a problem not uncommon in various industries, including healthcare, especially in high-stress environments like operating rooms.
Prof Ostroff emphasized that disrespectful comments not only impact staff morale, well-being, and productivity but also have adverse effects on patients. In surgical settings, where teamwork is crucial, incivility can contribute to poor communication, potentially leading to worse outcomes.
Researchers of the study emphasize that the repercussions extend widely, encompassing elevated staff turnover, diminished job satisfaction, decreased productivity, and a decline in adherence to infection control and medication protocols.
Numerous international attempts have been made to tackle the issue of inappropriate behavior within surgical teams, employing workshops and training sessions, but with limited success.
In an Adelaide-based study, an initial survey involving 74 staff members at a private hospital—encompassing surgeons, trainees, nurses, anaesthetists, and technicians—sought to capture instances of undesirable conduct in the operating theatre. Subsequently, eye signs were strategically placed a month later. A follow-up survey conducted seven weeks afterward revealed a significant impact. Particularly, theatre nurses reported a noticeable reduction in the occurrence of offensive and rude remarks.
According to Dr. Nicholas Wallwork, a participating surgeon in the study, the experiment underscores that individuals tend to alter their behavior, even subconsciously, when they perceive they are being monitored.
“Rudeness and bullying occur in operating theatres because the stakes are high,” said Dr. Wallwork. “There are at least six people working as a team in a confined space, under time pressures and with risks involved. A high-functioning stable team delivers better performance, but due to numerous factors this is sometimes difficult to achieve.”
“Poor communication is a recognised problem in our industry, and it is not always from the top down, but across teams.
“The selection and training process is arduous – it takes 10 years to qualify as a surgeon – and it is a very competitive, intensive, and results-driven environment.”
Dr. Wallwork indicated that intricate leadership setups, wherein surgeons exert direct clinical authority over the staff during a shift but do not serve as line managers outside the operating theatre, result in conflicts.
He further warned that that the failure to alter this structure, which contributes to elevated burnout rates and frequent staff turnover, will result in the industry encountering a crisis.
Professor Ostroff highlights that the study indicates that simple interventions can bring about a transformation in poor behavior.
She also pointed out that it is important to change the workplace culture, as in many healthcare settings, management is distant from the day-to-day workplace stressors, leading to a disconnect and a lack of understanding.
The study pinpointed four key areas requiring attention. Firstly, there is a demand for senior management to serve as role models, prioritizing and emphasizing respect within the workplace. Secondly, the importance of appreciating and acknowledging the value of employees emerged as a crucial aspect. Thirdly, fostering more open communication within teams and between staff and management is deemed essential. Lastly, the study highlights the necessity for greater clarity regarding roles. These findings have been published in PLOS ONE.
