Using the Observational Teamwork Assessment in Surgery Instrument to Measure RN Teamwork During Cardiac Surgery: Lessons Learned.

BACKGROUND Surgical teams aspire to be safe and avoid preventable deaths. A lack of teamwork has been associated with safety failures, including adverse events and errors. PURPOSE The purpose of the pilot study was to: (1) modify the Observational Teamwork Assessment in Surgery (OTAS) and the original data collection method to measure registered nurse (RN) teamwork during the intraoperative phase of 5 open heart surgical procedures and (2) recommend strategies to further test the reliability and validity of the modified OTAS. METHODS This was a pilot study of the OTAS using direct observation. RESULTS Although characterized as psychometrically rigorous in prior systematic reviews, using the OTAS to measure RN teamwork in the intraoperative phase of cardiac surgery revealed deficits in its content validity and reliability. The OTAS and its original data collection method were modified. CONCLUSION Recommendations for further use of the modified OTAS to increase its reliability and validity are given.