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PSNet: Patient Safety Network
Journal Article

Communication failures in the operating room: an observational classification of recurrent types and effects.

Lingard L, Espin S, Whyte S, et al. Quality & safety in health care. 2004;13:330-4.

This study used direct observation of 48 surgical procedures to characterize deficits in communication among team members.  Problematic communication occurred in nearly one-third of all exchanges between team members, and appeared to have direct effects on patient safety through increasing tension and creating the need for workarounds.  Communication and teamwork in the operating room was the subject of a classic study of safety culture.