Communication Culture [Neurosurgery Wiki]

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====== Communication Culture ======

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Studies have shown that healthcare [[team motivation]] strongly correlates with [[leadership style]], [[recognition]], [[workload balance]], and [[communication]] [[culture]]. (E.g., Shanafelt et al., 2017; West et al., 2016)

==== Definition ====
  
Communication culture refers to the shared norms, practices, and attitudes that shape how [[information]] is exchanged within a healthcare [[team]] or [[organization]]. It affects how openly, frequently, and effectively members communicate, especially across hierarchical boundaries.

==== Core Components ====
  * **Openness:** Team members feel comfortable speaking up, asking questions, and acknowledging uncertainties or errors.
  * **Respect:** Contributions are valued regardless of role or seniority.
  * **Feedback mechanisms:** Structured systems are in place for giving and receiving constructive feedback.
  * **Psychological safety:** Staff feel safe to express concerns without fear of judgment or retaliation.
  * **Clarity and consistency:** Communication is clear, precise, and aligned across team members.
  * **Interdisciplinary flow:** Information flows smoothly between nurses, doctors, residents, and administrative staff.

===== Importance in Neurosurgery =====
A strong communication culture is especially critical in neurosurgery due to:
  * High-pressure [[decision-making]]
  * Cross-disciplinary coordination (surgical, anesthetic, nursing)
  * Risk of severe patient harm from misunderstandings

Poor communication culture can lead to:
  * Increased medical [[error]]s
  * [[Burnout]] and [[disengagement]]
  * Hierarchical silos and missed opportunities for improvement


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In general, [[effective communication]] is crucial in the field of [[neurosurgery]], as it involves [[collaboration]] among a [[team]] of [[healthcare]] [[professional]]s, including [[neurosurgeon]]s, [[nurse]]s, [[anesthesiologist]]s, and other specialists. [[Briefing]]s, whether in the form of [[meeting]]s, [[presentation]]s, or [[written document]]s, play a vital [[role]] in ensuring that everyone involved in a [[case]] is well-informed and on the same page.

If "[[Neurosurgical Briefing]]" is a specific [[resource]] or [[tool]] tailored for neurosurgery [[communication]], its effectiveness would depend on factors such as the [[content]] provided, its relevance to the field, user reviews, and adoption by the neurosurgical [[community]].
----
Communication about [[patient]]s' goals and planned and potential [[treatment]] is central to advance [[care]] [[planning]]. Undertaking or confirming advance care plans is also essential to [[preoperative]] preparation, particularly among patients who are frail or will undergo [[high-risk surgery]].
----

In a [[systematic review]] related to nurse-[[physician]] [[collaboration]], House and Havens reported that
[[nurse]]s and physicians held different perceptions of [[collaboration]], shared decision making, [[teamwork]] and [[communication]]
((House S, Havens D 2017 Nurses' and physicians' perceptions
of nurse-physician collaboration: A systematic review
Journal of Nursing Administration 47 (3) 165–171)).

Communication failure and lack of [[collaboration]] among [[caregiver]]s have been identified as the leading root cause of sentinel events and a primary contributing factor of [[adverse event]]s and near misses in the clinical setting


of which 15-20% occurred in the operative setting 

((The Joint Commission TJC 2013 Sentinel event data root
causes by event type 2004-2012 Available from: http://www.jointcommission.org/assets/1/18/Root_Causes_Event_Type_04_4Q2012.pdf Accessed May 2018)).

The Institute of Medicine  (2003) reported that more than 98,000 patients die each year due to preventable medical [[error]]s.

((Institute of Medicine 2003 Health professional education: A
bridge to quality Washington DC, National Academies Press))
((United States Department of Veterans Affairs 2011 VA National Center for Patient Safety Available from: https://www.patientsafety.va.gov/ Accessed May 2018))

===== Open communication =====

[[Open communication]]


==== Example of a Healthy Communication Culture ====
> Residents are encouraged to voice doubts without fear.  
> Nurses contribute actively to preoperative planning.  
> Surgical errors are debriefed transparently.  
> Monthly meetings are held for open dialogue and shared learning.

==== Related Concepts ====
  * [[psychological_safety]]
  * [[leadership_style]]
  * [[feedback_culture]]
  * [[team_motivation]]

===== Improving Communication Culture =====

Improving communication culture requires intentional, systemic changes. Below are effective strategies:

==== 1. Establish Psychological Safety ====
  * Ensure all team members feel safe to express doubts or admit errors.
  * Promote learning over blame.

==== 2. Implement Regular Feedback Loops ====
  * Monthly feedback sessions (bidirectional).
  * Encourage upward feedback from all roles.

==== 3. Flatten Hierarchies ====
  * Value input from every team member.
  * Encourage informal communication where appropriate.

==== 4. Use Structured Communication Tools ====
  * Apply SBAR during handoffs and patient updates.
  * Standardize communication protocols across shifts.

==== 5. Daily Huddles and Briefings ====
  * Hold short multidisciplinary meetings to align on goals and risks.

==== 6. Conduct Post-Event Debriefs ====
  * Use non-punitive debriefings after critical incidents.
  * Include M&M rounds focused on systems improvement.

==== 7. Train Leaders ====
  * Provide training on empathetic communication and team facilitation.
  * Encourage leaders to model transparency and approachability.

==== 8. Monitor and Adjust ====
  * Use anonymous surveys to assess the communication environment.
  * Adapt strategies based on team feedback.

==== Related Pages ====
  * [[communication_culture]]
  * [[psychological_safety]]
  * [[team_dynamics]]
  * [[feedback_culture]]