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Purpose

Communication is crucial for the performance of surgical teams and thus patient safety. This field study aims to investigate how the Silent Operating Theatre Optimisation System (SOTOS), a technical noise reduction and communication system, influences communication during surgery.

Design/methodology/approach

In 22 heart surgeries (11 with SOTOS = experimental; 11 without = control), i.e. coronary bypass grafting and valve replacements, communication of 46 team members was recorded, transcribed, segmented and coded for the last two of five surgical phases, the critical Phase 4 and the routine Phase 5. All 47,387 communication units were coded as case-relevant-communication (CRC) or case-irrelevant-communication (CIC). Communication was analysed statistically via multilevel models.

Findings

The SOTOS led to less communication compared to regular operations (F(1, 21.39) = 11.33, p = 0.003). Concerning CRC, no difference was found between treatment conditions across both phases (F(1, 21.69) = 1.40, p = 0.249), but a post hoc test revealed a significantly higher CRC mean for the experimental group compared to the control group in the critical phase 4 (F(1, 20.92) = 4.47, p = 0.047). No difference in CIC in routine Phase 5 between the treatment conditions was found (F(1, 20.30) = 0.6, p = 0.446).

Research limitations/implications

The SOTOS led to less communication compared to regular operations, F(1, 21.39) = 11.33, p = 0.003, b = −1.23 segments/minute, 95%-CI[−2.00; −0.46]. Concerning CRC, no difference was found between treatment conditions across both phases, F(1, 21.69) = 1.40, p = 0.249, b = 0.08 proportion of CRC, 95%-CI[0.60; 0.71], but a post hoc test revealed a significantly higher CRC mean for the experimental group compared to the control group in the critical Phase 4, F(1, 20.92) = 4.47, p = 0.047, b = 0.08 proportion of CRC, 95%-CI[0.00; 0.16]. No difference in CIC in routine Phase 5 between the treatment conditions was found, F(1, 20.30) = 0.6, p = 0.446, b = 0.02 proportion of CIC, 95%-CIxD;xA;[−0.04; 0.09].

Originality/value

In sum, team members communicated less with the SOTOS, which reduces the microbial load and more CRC in critical Phase 4 and a constant CIC-level in the critical and the routine Phases were found in the SOTOS group. These results hint at SOTOS enhancing information sharing and team climate, while reducing distractive effects.

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