The Influence of Operating Room Handoffs on Teamwork, Stress, and Work: a 360 degree Evaluation of Team Shared Situation Awareness

Teamwork is important in the operating room. Team members rely on each other’s expertise for successful task completion. Because of lunch and change of shift breaks, handoffs occur frequently, but little is known about their effect on team performance, or the team’s awareness of these changes. We performed a 360 degree evaluation of the effect of operating room handoffs on teamwork, stress, and work among the members of the operative team (surgeons, anesthesia providers, circulator nurses, scrub technicians). An independent observer also evaluated the effect of handoffs. We specifically examined for evidence of shared team situation awareness. Surgical attendings reported decreased teamwork, increased stress, and increased work due to handoffs in about 30-50% of cases; while nursing personnel reported handoffs to be seamless, and have little effect (5%) on teamwork, stress, or work. This demonstrated a lack of shared team situation awareness, among operating room teams, regarding the influence of handoffs on team performance.