Bias in the trauma bay: A multicenter qualitative study on team communication.
Journal
The journal of trauma and acute care surgery
ISSN: 2163-0763
Titre abrégé: J Trauma Acute Care Surg
Pays: United States
ID NLM: 101570622
Informations de publication
Date de publication:
01 06 2023
01 06 2023
Historique:
medline:
24
5
2023
pubmed:
8
3
2023
entrez:
7
3
2023
Statut:
ppublish
Résumé
Team communication and bias in and out of the operating room have been shown to impact patient outcomes. Limited data exist regarding the impact of communication bias during trauma resuscitation and multidisciplinary team performance on patient outcomes. We sought to characterize bias in communication among health care clinicians during trauma resuscitations. Participation from multidisciplinary trauma team members (emergency medicine and surgery faculty, residents, nurses, medical students, emergency medical services personnel) was solicited from verified level 1 trauma centers. Comprehensive semistructured interviews were conducted and recorded for analysis; sample size was determined by saturation. Interviews were led by a team of doctorate communications experts. Central themes regarding bias were identified using Leximancer analytic software (Leximancer Pty Ltd., Brisbane, Australia). Interviews with 40 team members (54% female, 82% White) from 5 geographically diverse Level 1 trauma centers were conducted. More than 14,000 words were analyzed. Statements regarding bias were analyzed and revealed a consensus that multiple forms of communication bias are present in the trauma bay. The presence of bias is primarily related to sex but was also influenced by race, experience, and occasionally the leader's age, weight, and height. The most commonly described targets of bias were females and non-White providers unfamiliar to the rest of the trauma team. Most common sources of bias were White male surgeons, female nurses, and nonhospital staff. Participants perceived bias being unconscious but affecting patient care. Bias in the trauma bay is a barrier to effective team communication. Identification of common targets and sources of biases may lead to more effective communication and workflow in the trauma bay. Prognostic and Epidemiological; Level IV.
Sections du résumé
BACKGROUND
Team communication and bias in and out of the operating room have been shown to impact patient outcomes. Limited data exist regarding the impact of communication bias during trauma resuscitation and multidisciplinary team performance on patient outcomes. We sought to characterize bias in communication among health care clinicians during trauma resuscitations.
METHODS
Participation from multidisciplinary trauma team members (emergency medicine and surgery faculty, residents, nurses, medical students, emergency medical services personnel) was solicited from verified level 1 trauma centers. Comprehensive semistructured interviews were conducted and recorded for analysis; sample size was determined by saturation. Interviews were led by a team of doctorate communications experts. Central themes regarding bias were identified using Leximancer analytic software (Leximancer Pty Ltd., Brisbane, Australia).
RESULTS
Interviews with 40 team members (54% female, 82% White) from 5 geographically diverse Level 1 trauma centers were conducted. More than 14,000 words were analyzed. Statements regarding bias were analyzed and revealed a consensus that multiple forms of communication bias are present in the trauma bay. The presence of bias is primarily related to sex but was also influenced by race, experience, and occasionally the leader's age, weight, and height. The most commonly described targets of bias were females and non-White providers unfamiliar to the rest of the trauma team. Most common sources of bias were White male surgeons, female nurses, and nonhospital staff. Participants perceived bias being unconscious but affecting patient care.
CONCLUSION
Bias in the trauma bay is a barrier to effective team communication. Identification of common targets and sources of biases may lead to more effective communication and workflow in the trauma bay.
LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.
Identifiants
pubmed: 36880706
doi: 10.1097/TA.0000000000003897
pii: 01586154-202306000-00004
doi:
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
771-777Informations de copyright
Copyright © 2023 American Association for the Surgery of Trauma.
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