What's in a Name? Enhancing Communication in the Operating Room With the Use of Names and Roles on Surgical Caps

Abstract Objective : A pilot study was conducted in a tertiary referral center to assess whether wearing caps labeled with providers' names and roles has an impact on communication in the operating room (OR). Methods : Two obstetricians observed surgeries for name uses and missed communications. Following each case, all providers were given a short survey that queried their attitude about the use of labeled surgical caps, their ability to know the names and roles of other providers during a case, and the impact of scub attire on identifying others. Additionally they were asked to rate the ease of communication and their ability to recall name and roles of the personnel specific to the case in which they had just participated. Patients were asked how they perceived the use of labeled caps by providers. Results : Twenty scheduled Cesarean deliveries were randomized to either labeled (10) or non-labeled (10) surgical caps. A total of 129 providers participated in the study with 117 providing responses to the survey; 56 in the unlabeled cap and 61 in the labeled cap cases. Providers reported that they knew the names and roles of colleagues more often with labeled caps than with non-labeled caps. Participants reported knowing names of colleagues with labeled caps –77.8% with labeled caps vs. 55% with unlabeled caps (95% confidence interval 64.4% - 88.0% vs. 41.6% - 67.9%, p = 0.011). Participants reported knowing the roles of colleagues 92.5% vs. 78.3% with labeled vs. non- labeled caps (95% confidence interval 81.8%-98.0% vs. 65.8%-88.0%, p = 0.036). Name uses increased (43 vs. 34 instances, p = 0.208) and missed communications decreased (16 vs. 20 instances, p = 0.614) when labeled caps were worn. Providers and patients had an overwhelmingly positive response to labeled caps. Providers reported communication with other team members as "easy and without barriers" more frequently (90.7% vs 65%) with labeled caps than without (95% confidence interval 79.7% - 96.9% labeled vs. 51.6% -76.9% unlabeled, p = 0.001) Conclusions : Our pilot study demonstrated that wearing labeled caps in the OR led to more frequent name uses and less frequent missed communications. Notably, providers and patients embraced the concept of labeled caps and perceived wearing labeled caps as improving communication in the OR.