• Brigid M Gillespie, Karleen Gwinner, Wendy Chaboyer, and Nicole Fairweather.
• NHMRC Research Centre for Excellence in Nursing Interventions (NCREN), School of Nursing & Midwifery, Parklands Dr, Griffith University, Gold Coast 4222, Australia. b.gillespie@griffith.edu.au
• J Interprof Care. 2013 Sep 1;27(5):387-93.

AbstractAs a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: "building shared understandings through open communication"; "managing contextual stressors in a hierarchical environment" and "intermittent membership influences team performance". In creating a safety culture in a healthcare organisation, a team's optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.

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