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Hello, everyone.
For this week's Meet the Researchers Series,
we're having Joseph Carpini who is doing his PhD at the UWA Business School.
Welcome, Joseph.
>> Thanks for having me.
It's a pleasure to be here.
>> Thank you.
Joseph, I know you're doing a lot of interesting work in hospitals,
particularly looking at how surgical teams work together.
Can you tell us a bit more about your project?
>> Absolutely.
Basically, I think the easiest way to explain the project that I'm doing is to
ask a maybe not so easy question.
Imagine you or somebody you love had to go in for an elective surgery.
So, not an emergency where... you
actually have a choice about the surgeon you choose.
You have two options.
The first option is a surgeon who is a technical master but
actually, is not very interpersonally skilled at all.
The second surgeon is of average skill but
quite good interpersonally, so really strong coordination and team abilities.
Which one would you choose for yourself or somebody you love?
>> I think, I might take the first.
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>> Absolutely, I think a lot of us would naturally take the first surgeon, that one
with the high mastery but not necessarily interpersonally skilled at all.
But there is a growing body of literature that suggests that actually
the non-technical skills, communication,
coordination are important aspects of surgery.
For example, we know that there is approximately a 22% adverse event
rate in surgery and in 13% of those cases, there's patient disability,
in the long term, about 18 months later.
In about 4% of those cases, we see patient mortality.
We're not talking about little errors here,
we're talking about things that really have a huge impact for patients.
The real issue that we find is actually the fact that we
don't really understand that much about what causes these errors.
What's causing that 22%?
>> Yeah. >> So
that's really where our research sits and
we're really trying to understand the interpersonals, the team and
the coordination aspect of surgery in order to make surgery safer for patients.
More efficient so that we can get more patients in and out of the operating
theater, and ultimately, reduce the number of mortalities that occur in surgery.
>> Wow, this sounds like really interesting but also complicated work.
What did you do with the surgical teams exactly?
>> You're right, it is a really complicated issue, so
we need to address it from a lot of different approaches.
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Basically, what ends up happening is at the beginning of a day, I choose a theater
to observe, and I spend the entire day in that theater observing between three and
eight surgical procedures.
Then what ends up happening is throughout the course of the day,
I take structured notes on who's talking to who.
What are they saying?
Is there a communication failure?
And if there is a failure, what is the observable consequence of it?
Then what I do at the very end of the day, when everybody's wrapping up,
is I chase them down to ask them to do a really short questionnaire.
Somewhere between five and ten minutes that tries to assess
the extent to which they think that there was good communication, teamwork, and
how they think they performed technically.
What I've ended up doing in the end is that I've collected about 206 surgical
episodes, taking notes.
I collected over 210 surveys, representing about 64 different surgical teams.
All of that, in addition to the over 2,000 pages of handwritten notes that I've
taken in theater, in addition to the hospital records that I've received.
So to say the least, there's a lot of data involved.
>> Yeah. I know,
Joseph, this project is still ongoing but do you have some data or
findings you can share with us?
Absolutely, we have some preliminary finding from our first study that we did.
Basically, let's think back to that scenario that I presented at the very
beginning, with those two surgeons.
The first surgeon is the technical master but interpersonally a monster.
The second surgeon, not the best necessarily,
average skills but is a really strong communicator.
Our results, thus far, suggest that actually you're better off choosing
the second surgeon as that surgeon is less likely to encounter a near miss.
A near miss is when something almost goes wrong but doesn't
either because somebody said something and interjects or just out of sheer luck.
The real kicker, though, is the fact that we know that a near miss oftentimes turns
into either a minor or a major complication.
That's when something actually does go wrong.
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Furthermore, what we ended up finding was that the extent to which the team
perceives strong nontechnical skills, like communication and
team work, that was actually a better predictor of those minor and
major complications than the team's technical abilities.
Furthermore, we ended up finding that their ability to coordinate and
collaborate with one another was the single best predictor
in explaining surgical efficiency.
So it turns out that, actually,
the second surgeon would probably be the best in terms of patient outcome for
the hospital and probably in preventing patient mortality.
We're currently
in the process of examining some additional variables and
to confirm those results using another data set that we've collected but
you'll find updates on the Centre for Safety's website at UWA.
>> Sounds great, thanks so much Joseph.
>> Thanks for having me.
>> Thank you.
[MUSIC]
Sharon ParkerProfessor
Mark GriffinProfessor
Patrick DunlopLecturer
Marylène GagnéProfessor
Kerrie UnsworthHonorary Research Fellow
Zhijun ChenLecturer
Aleksandra LuksyteSenior Lecturer
Lena WangProgram Manager
