Differences in Nurse and Surgeon Perceptions of Teamwork: Implications for Use of a Briefing Checklist in the OR BRIAN T. CARNEY, MD; PRISCILLA WEST, MPH; JULIA NEILY, RN, MS, MPH; PETER D. MILLS, PhD, MS; JAMES P. BAGIAN, MD, PE ABSTRACT The quality of teamwork among health care professionals is known to affect patient outcomes. In the OR, surgeons report more favorable perceptions of communication during procedures and of teamwork effectiveness than do nurses. We undertook a quality improvement project in the Veterans Health Administration to confirm reported team- work differences between perioperative nurses and surgeons and to examine the impli- cations of these differences for improving practice patterns in the OR. The Safety Attitudes Questionnaire, which measures safety culture, including the quality of com- munication and collaboration among health care providers who routinely work together, was administered in 34 hospitals. Perioperative nurses who participated in the survey rated teamwork higher with other nurses than with surgeons, but surgeons rated team- work high with each other and with nurses. On five of six communication and collaboration items, surgeons had a significantly more favorable perception than did perioperative nurses. To increase the likelihood of success when implementing the use of checklist-based crew resource management tools, such as the World Health Organization’s Surgical Safety Checklist, project leaders should anticipate differ- ences in perception between members of the different professions that must be over- come if teamwork is to be improved. AORN J 91 (June 2010) 722-729. © AORN, Inc, 2010. doi: 10.1016/j.aorn.2009.11.066 Key words: communication, crew resource management, safety culture, team training. T o reduce adverse events, many organiza- tions, including the Veterans Health Ad- ministration (VHA), have committed to developing a culture of safety. 1 Safety culture means different things to different people, but it is generally agreed to be a professional culture that promotes effective and efficient communication among clinicians that is not hampered by hierarchi- cal status or personality differences. Patient care is put before conformance to social or cultural norms, and best practices are determined and used regard- less of personal preferences or habits. doi: 10.1016/j.aorn.2009.11.066 722 AORN Journal ● June 2010 Vol 91 No 6 © AORN, Inc, 2010