Observational Teamwork Assessment for Surgery (OTAS)

A brief overview

Researchers in the Clinical Safety Research Unit designed OTAS in order to measure the performance of interprofessional teamwork in the operating theatre. The aim was to devise measures that would help both researchers and clinicians assess and measure teamwork in the operating theatre. The rationale is that, if it is possible to discriminate levels of team performance in surgery we can then identify teams that need improvement and apply the teamwork measures in training.

In principle, the instrument is straightforward; it is a set of measures, comprising a task checklist and five behavioural scales for rating teamwork behaviour. The content of the task list will be clear for anyone familiar with the routine process of surgery and the form of the rating scales will be familiar to many researchers. However, for the benefit of those researchers or clinicians considering teamwork measurement for the first time, we recommend a note of caution. Measuring teamwork is not a simple matter, and developing valid measures of team performance is not straightforward. Valid and reliable measures depend on a structure and content appropriate, in theoretical and practical terms, to the object measured and purpose of measurement.

OTAS has undergone some considerable development work, and data is available on its use; this we cite in the dissemination below. To date, we can safely say that OTAS has face validity, some content validity and reliability. This does not mean that readers should assume OTAS as definitive, nor valid for formally assessing surgical teams; the instrument needs more rigorous testing and development for that to be the case. However, we can say that the structure and content of the instrument and its associated research may serve as a basis for simply researching interprofessional teamwork in surgery. We hope other researchers will consider participating in this research and help build on what is an important line of work, for the purpose of patient safety.

OTAS Short User Guide: To download the OTAS manual, click here

Dissemination of OTAS-related research

Peer reviewed journal publications

Healey, A. N., Undre, S., Sevdalis, N., Koutantji, M., & Vincent, C. A. (2006). The complexity of measuring interprofessional teamwork in the operating theatre. Journal of Interprofessional Care, 20, 485-495.

Healey AN, Undre S, Vincent CA. (2006) Defining the technical skills of teamwork in surgery. Quality and Safety in Healthcare, 15, 231-234.

Undre S, Healey AN, Darzi A, Vincent CA. (2006) Observational teamwork assessment in surgery: a feasibility study. World Journal of Surgery, 30, 1774-1783.

Healey AN, Undre S, Vincent CA.(2004). Developing observational measures of performance in surgical teams. Quality and Safety in Health Care, 13 (Suppl 1), i33-i40.

Papers in progress or in press

Healey AN, Primus CP, Koutantji M. (in press) Quantifying distraction and interruption in urological surgery. Quality and Safety in Health Care.

Healey AN, Vincent CA. (in press) The systems of surgery. Theoretical Issues in Ergonomic Science.

Primus CP, Healey AN, Undre S. (in press) Distraction in the urology operating theatre. British Journal of Urology International.

Undre S, Sevdalis N, Healey AN, Darzi A, Vincent C. (in press) The Observational Teamwork Assessment for Surgery (OTAS): Refinement and Application in Urological Surgery. World Journal of Surgery.

Healey AN, Olsen S, Davies R, Vincent CA. (in progress ) Preoperative teamwork may affect intra-operative interference. Cognition,Technology and Work, Special Issue: Enhancing the System of Surgery .

Conferences

Sevdalis N, Undre S, Healy AN, Vincent CA, Darzi A. Observational teamwork assessment for surgery: an empirical review. International Association for Applied Psychology. July 2006, Athens, Greece.

Undre S, Sevdalis N. Team performance in the operating theatre. National Patient Safety Agency staff research skills seminar. July 2006, London, UK.

Undre S, Healey A, Vincent CA, Darzi A. Observational teamwork assessment for surgery (OTAS) oral presentation European Association of Work and Organisational Psychology. August 2004, Istanbul , Turkey.

Undre S, Healey A, Vincent CA, Darzi A. Observational teamwork assessment for surgery (OTAS). BAUS 2004 , Harrogate, UK; BJUI 93 (Supplement 4) 115 June 2004.

Undre S*, Healey A, Vincent CA, Darzi A. Observational teamwork assessment for surgery (OTAS) RSM section of urology, Presidents Day Meeting . * Winner of the Geoffrey Chisolm communication prize, May 2004, London , UK.

The CSRU teams research group: Shabnam Undre, Andrew Healey, Nick Sevdalis, Mary Koutantji, Peter McCulloch, and Charles Vincent