Both the National Academy of Medicine and The Joint Commission have cited lack of teamwork as a principal cause of inefficiency and medical error in the OR, and highlighted improved communication as a major priority in this arena. In addition to the potential patient safety benefits, increased OR efficiency could translate into reduced costs, earlier finishes, and/or increased case volume, all increasingly important in the current cost-conscious era.
Over the last several years, the senior author (S.E.M.) has required the surgical resident in her cases to complete a large, easily-visible whiteboard within the OR that details the patient’s history and physical and full operative sequence. Anecdotal satisfaction from OR staff has noticeably improved with this strategy. Theoretically, facilitating preoperative and intraoperative communication via such a whiteboard strategy offers profound benefits, including augmenting case flow by identifying subsequent operative steps to all team members, improving case efficiency by avoiding opening of unnecessary equipment or other potential sources of delay, improving case involvement by making staff more satisfied, and enhancing case preparedness by requiring the assisting resident to outline all the pertinent patient background information and operative steps.
Based on this experience, we performed a pilot innovation study to see if use of an OR whiteboard improves team dynamics along the dimensions of case flow, efficiency, involvement, and preparedness, and whether these metrics are further improved by the addition of a supplies category listing needing equipment.