Impact of Teamwork and Communication Training on Team Psychological Safety

Abstract

Purpose: This Quality Improvement project evaluates the impact of teamwork and communication training, supplemented by post-surgical debriefs, on the self-assessed psychological safety of operating room (OR) teams. Adverse surgical events, affecting 14.4% of surgical patients despite safety protocols, harm not only patients but also families, providers, and communities. The literature identifies discomfort in speaking up as a primary cause of errors, as psychologically unsafe teams hesitate to raise concerns in the OR. Methods: Study participants, including physicians, anesthesiologists, technicians, nurses, and vendors, were selected by the site leader. Before the intervention, each person completed a baseline Surgical Team Member Experience Survey, adapted from Amy Edmondson’s Psychological Safety Survey. Training in communication and teamwork utilized modified TeamSTEPPS resources and was delivered via video or a tailored educational packet. Post-surgical three-question debriefs focused on successes, areas for improvement, and actionable steps, identifying issues in 59.4% of cases. After the intervention, participants completed the survey again and assessed their communication, teamwork, and confidence in speaking up, as well as providing open-ended feedback on process improvements. Results: Thirteen members from three high-performing surgical teams participated in communication and teamwork training, followed by six weeks of structured three-question debriefs after 79 surgical cases, which resulted in an 8% increase in self-reported psychological safety. Survey scores improved from 60 to 64.6 out of 70. Improvements were noted across all seven survey areas, aligning with existing literature on enhancing team communication and patient outcomes. Despite non-randomized team selection, the results highlight the potential applicability of the training to other surgical teams. Actionable items were identified in 44% of cases, highlighting the importance of refining communication, even in high-performing teams, to address challenges in high-stress environments such as operating rooms and healthcare in general. Implications for Practice: Interdisciplinary communication and teamwork training, coupled with structured debriefing, enhance psychological safety among surgical teams and show potential for broader application in healthcare. While the study's small sample size limits generalizability, it lays a foundation for further research. Future efforts should test these methods with less experienced teams and explore links between psychological safety, employee engagement, and retention amid workforce shortages. Remote implementation methods also warrant further study to assess their effectiveness and scalability.