Teamwork and stress in routine interventions: an observational study of multiprofessional OR teams

Background Effective interprofessional teamwork and stress are important factors for quality of care and patient safety in the operating room (OR); however, there are just a few systematic investigations into the relationship of OR teamwork and occupational stress. Objective Determination of the relationship between interdisciplinary OR teamwork and stress in routine procedures, for the whole OR team as well as individual professions. Methods Multimethod study with expert observations using a standardized observation tool (OTAS-D) and systematic self-reports of the entire OR team. A total of 64 elective interventions across different surgical departments were observed. Relationships were calculated using mixed-effects regression models with control of procedural and provider characteristics. Results The quality of the intraoperative teamwork was at a medium level. Reported stress during interventions was at comparatively low levels, with significant differences between the professions of surgery, nursing and anesthesiology. Members of the surgical team reported the highest stress levels. An association between teamwork and perceived stress could not be determined for the entire OR team; however, within the surgical sub-team there were significant positive correlations for the quality of teamwork and stress (as well as for the teamwork dimensions of collaboration and leadership). For the nursing sub-team, we observed significant negative correlations with overall teamwork as well as with the dimension team monitoring. Conclusion The findings suggest a profession-specific relationship between OR teamwork and occupational stress. Further research is necessary to investigate to what extent successful OR teamwork during routine procedures contributes to intraoperative stress.