Team collaboration and interaction in the operating theatre: A conversation analytic study

This thesis examines how surgical teams collaboratively achieve patient safety through moment-by-moment communication during routine activities in the operating theatre. Previous studies have revealed that miscommunication, interruptions, and knowledge deficits can disrupt team collaboration in healthcare and lead to potential adverse events and errors. The aim of this thesis is to explore how interdisciplinary surgical team members collaborate to carry out crucial everyday care activities across the patient’s perioperative journey. This study employs a qualitative descriptive methodology, applying Conversation Analysis to continuous video recordings of three surgical cases. The analysis focuses on how team members use talk and embodiment to successfully accomplish a range of tasks during these surgical cases. This study examines two key sets of activities achieved through team collaboration: 1) the transfer of patients from a bed onto an operating theatre table; and 2) the recruitment of assistance between team members. When transferring awake patients from a bed onto an operating theatre table, team members oriented to a specific structure in this activity. There was substantial variation in how this structure was realised, how different team members participated in it, and how they involved the patient. When team members recruit assistance from one another, either by requesting or offering assistance, they orient to a range of factors in designing their interactional conduct. In particular, when participants use talk to manage the pursuit of assistance, it regularly shows that there may be barriers to fulfilment or completion of the task. This study demonstrates that team collaboration is key to performing care activities in the operating theatre. The thesis contributes to original empirical data and conceptual insights to the fields of team collaboration, communication, conversation analysis and patient safety. It highlights how surgical team members accomplish routine work activities, and the structural organisation of teams are realised through patterns of interaction; particularly, how deontic authority is distributed in these teams. The findings of this study can enhance future education and training for interdisciplinary team members, as well as contribute to curriculum development in relation to team collaboration and communication. Moreover, it can contribute to implications for training, enhancing future policies, standards, and guidelines, and communication-based interventions in clinical education that will enhance team collaboration and patient safety.