Carolinas HealthCare System

The operating room (OR) can be a stressful environment for patients, surgeons and their teams. We are focused on reducing this stress, helping patients receive the best possible outcomes. One of our projects in this area focuses on identifying technical and non-technical skills “errors” among healthcare providers and sharing feedback. Our surgeons participate in a curriculum that offers interactive video reviews and simulation-based workshops by experts in recognizing and preventing errors. Our providers also receive evaluations for non-technical skills (i.e., communication, situation awareness, teamwork and problem solving).

After tracking providers’ progress, we saw decreases in the number of "interruptions" they had during surgery in the OR. We saw scores improve 5.4 percent. We also decreased unnecessary delays in surgery by 94 percent among our trained surgeons and 83 percent among untrained populations.

Also, video-based performance assessments of surgeons’ technical and non-technical skills can help identify skills that might need to improve. This has called into question whether such assessments should be part of normal surgical practice. This project shows that surgeon behavioral change is possible through ongoing training.