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)

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.

• 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.

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 errors
• Burnout and disengagement
• Hierarchical silos and missed opportunities for improvement

In general, effective communication is crucial in the field of neurosurgery, as it involves collaboration among a team of healthcare professionals, including neurosurgeons, nurses, anesthesiologists, and other specialists. Briefings, whether in the form of meetings, presentations, or written documents, 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 patients' 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 nurses and physicians held different perceptions of collaboration, shared decision making, teamwork and communication ¹⁾.

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

of which 15-20% occurred in the operative setting

²⁾.

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

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Open communication

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.

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

• Ensure all team members feel safe to express doubts or admit errors.
• Promote learning over blame.

• Monthly feedback sessions (bidirectional).
• Encourage upward feedback from all roles.

• Value input from every team member.
• Encourage informal communication where appropriate.

• Apply SBAR during handoffs and patient updates.
• Standardize communication protocols across shifts.

• Hold short multidisciplinary meetings to align on goals and risks.

• Use non-punitive debriefings after critical incidents.
• Include M&M rounds focused on systems improvement.

• Provide training on empathetic communication and team facilitation.
• Encourage leaders to model transparency and approachability.

• Use anonymous surveys to assess the communication environment.
• Adapt strategies based on team feedback.

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