Mixed surgical teams lead to less medical error

Jul 03, 2018

Calm down. I’m the boss

SURGEONS are people, and people are animals, and animals often fight. Which is why Frans de Waal, an expert on animal behaviour, has turned his attention to the operating theatre to see if the methods he honed studying chimpanzees might be used to improve surgical practice.

Dr de Waal—and, more particularly Laura Jones, his colleague at Emory University in Atlanta, Georgia, who did the actual field work—used those methods to construct ethograms of surgical teams. An ethogram is a list of all the types of behaviour that occur within a group of animals. To draw up these lists Dr Jones observed interactions between 400 doctors, nurses and technicians during 200 operations. She logged all the non-technical communications she spotted, and classified them as “co-operative” (likely to lead to better surgical outcomes), “conflictive” (potentially jeopardising patient safety) or neutral.

As she describes in the Proceedings of the National Academy of Sciences, after analysing each of more than 6,000 exchanged insults and pleasantries, she found that surgical communication does indeed mimic wild-animal behaviour, both collaborative and hostile. In particular, as happens among wild animals, individuals jostle for dominance with others of their own sex...

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