Safety amid the scalpels: creating psychological safety in the operating room.

We briefly review the concept of psychological safety and discuss the actions that can create it in the anesthesiologist's work environment. The interest in psychological safety has grown in popularity since the publication of Amy Edmondson's book The Fearless Organization in 2018. While the concept and its benefits are described in the healthcare literature, the specific actions necessary to create it are often not. To ensure patient safety, we want members of the teams we lead to be comfortable sharing emerging problems that they see before we become aware of them. As educators, we want trainees to approach us when they do not understand something and openly participate and contribute without the fear of how others will perceive them. These scenarios require an environment of psychological safety - the ability to ask for help, admit mistakes, and be respectfully forthright with unpopular beliefs without the fear of being ostracized or ignored. Methods for creating an environment of psychological safety will be discussed.

Cohen JB ，Feldman-Brillembourg JA ，Cheng J ，Rangrass G ... -  《-》

Building a collaborative culture in cardiothoracic operating rooms: pre and postintervention study protocol for evaluation of the implementation of teamSTEPPS training and the impact on perceived psychological safety.

The importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment. This study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA. All team members participating in cardiac and thoracic OR cases during this 17-month study period will be identified by the primary surgical staff attending on the OR schedule.TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) training course will be taught to all CT OR staff. Before TeamSTEPPS training, staff will respond to a 39-item questionnaire that includes constructs from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, Edmondson's 'Measure of psychological safety' questionnaire, and questionnaires on turnover intentions, job satisfaction and 'burnout'. The questionnaires will be readministered at 6 and 12 months.The primary outcomes to be assessed include the perceived psychological safety of CT OR team members, the overall effect of TeamSTEPPS on burnout and job satisfaction, and observed turnover rate among the OR nurses. As secondary outcomes, we will be assessing self-reported rates of medical error and near misses in the ORs with a questionnaire at the end of each case. Ethics approval is not indicated as this project does not meet the federal definitions of research requiring the oversight of the Institutional Review Board (IRB). Patient health information (PHI) will not be generated during the implementation of this project. Results of the trial will be made accessible to the public when published in a peer-reviewed journal following the completion of the study.

Dahl AB ，Ben Abdallah A ，Maniar H ，Avidan MS ，Bollini ML ，Patterson GA ，Steinberg A ，Scaggs K ，Dribin BV ，Ridley CH ... -  《BMJ Open》

Persistence of unsafe practice in everyday work: an exploration of organizational and psychological factors constraining safety in the operating room.

Espin S ，Lingard L ，Baker GR ，Regehr G ... -  《-》

FOCUS: the Society of Cardiovascular Anesthesiologists' initiative to improve quality and safety in the cardiovascular operating room.

Barbeito A ，Lau WT ，Weitzel N ，Abernathy JH 3rd ，Wahr J ，Mark JB ... -  《-》

Improving departmental psychological safety through a medical school-wide initiative.

Porter-Stransky KA ，Horneffer-Ginter KJ ，Bauler LD ，Gibson KM ，Haymaker CM ，Rothney M ... -  《BMC Medical Education》