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L-R: Dr. Alexander Villafranca, co-lead author, Dr. Eric Jacobsohn, senior author, Ian Fast, co-lead author

Study finds that disruptive behaviour in operating rooms often goes unreported

January 16, 2020 — 

University of Manitoba researchers have found that disruptive behaviours are happening all too often in the operating room (OR) – and many clinicians who see the behaviour are not reporting it to management.

A new study, published in the Canadian Journal of Anesthesia, found that almost all clinicians (97 per cent) did not report all of the disruptive behaviour they observed, and three out of every 10 clinicians never reported the behaviour at all. Clinicians who were young, female or not in management were more likely to never report the behaviour.

Additionally, only one in five clinicians said that they were satisfied with management’s response to the issue.

“Disruptive behaviours range from incivility to egregious abuse, and are important because they not only affect the well-being of those working in the operating room, but can also undermine patient care,” said anesthesiologist Dr. Eric Jacobsohn, senior author and associate dean of professionalism, Max Rady College of Medicine, Rady Faculty of Health Sciences.

The authors surveyed clinicians from seven countries who worked in the OR, asking about the proportion of disruptive behaviour the clinicians reported to management, and the clinicians’ satisfaction with management’s response to the issue.  The survey was completed by 4775 operating room clinicians.

“Management can only respond to incidents that they are aware of. Because of this, it is essential that clinicians who witness disruptive behaviours report them promptly to management,” said Dr. Alexander Villafranca, co-lead author and research associate in the department of anesthesiology, perioperative and pain medicine, Max Rady College of Medicine.

The study was complemented by an accompanying editorial by researchers at Queens University, which congratulated the authors for “developing and validating a robust survey tool for research in this area” and stressed that more needs to be done in order to increase reporting and “conquer the silence.”

“We need to design reporting systems that clinicians will use, and ensure that managers respond to reports in ways that clinicians think are fair and just,” said co-lead author Ian Fast, first-year student at the Max Rady College of Medicine and research technician, department of department of anesthesiology, perioperative and pain medicine, Max Rady College of Medicine.

This research builds on the team’s previous research, which found that a staggering 97 per cent of clinicians reported being exposed to disruptive behaviour in the operating room. The average clinician reported being exposed to 61 incidents in the preceding year.

The research group’s future work will focus on developing tools that management can use to evaluate the appropriateness of clinician responses to disruptive behaviour, since the manner in which victims and witnesses react can either improve or worsen the consequences of disruptive behaviour.

 

Other authors:

Dr. Chris Christodoulou, head, department of anesthesiology, perioperative and pain medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba

Mrs. Kirby Magid, research technician, department of anesthesiology, perioperative and pain medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba.

Dr. Bernadette Henrichs, Goldfarb School of Nursing, Barnes Jewish College, St. Louis, MO, USA.

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