Team strategies are key to improving complex care processes. This review focuses on cardiothoracic surgery and the need for team approaches to enhance the safety of care in this specialty. The authors suggest that nontechnical skill development for surgical team leaders and structured communication can improve team performance.

Incident analysis enables learning from errors. This commentary explores elements of successful event investigation such as determining causal factors, describes root cause analysis, and reviews biases that can influence such investigations.

… and prevent missteps in the operating room. … Graling PR, Sanchez JA. Learning and Mindfulness: Improving Perioperative …

The Society of Thoracic Surgeons National Database collects data to promote transparency and enhance technical expertise. Exploring safety sciences in cardiothoracic surgery, this commentary discusses how human error, accident causation, and high reliability can improve safety of care delivered by cardiac surgical teams.

This study found that cardiac surgical teams had a more positive safety culture (as measured by the AHRQ Hospital Survey on Patient Safety Culture) than other surgical teams. Similar to prior studies in which managers reported a more positive safety culture than frontline staff, in this study surgeons reported more optimal safety culture compared to nurses and perfusionists. This gap in perceived safety culture requires further study.

This scientific statement from the American Heart Association (AHA) reviews the current state of knowledge on safety issues in the operating room (OR) and provides detailed recommendations for hospitals to implement to improve safety and patient outcomes. These recommendations include using checklists and formal handoff protocols for every procedure, teamwork training and other approaches to enhance safety culture, applying human factors engineering principles to optimize OR design and minimize fatigue, and taking steps to discourage disruptive behavior by clinicians. AHA scientific statements, which are considered the standard of care for cardiac patients, have traditionally focused on clinical issues, but this article (and an earlier statement on medication error prevention) illustrates the critical importance of ensuring safety in this complex group of patients.