Quantification of surgical team communication patterns related to high reliability organization principles

An exploratory study on high reliability organization principles in healthcare communication analyzed through recurrence quantification analysis, as well as conceptual recurrence analysis, was conducted. The research aimed to establish a set of high reliability organization (HRO) principles and recurrence metrics associated with the performance of surgical teams based on their communication patterns. The relationship between the communication metrics and the teams’ performance – the time for the surgical teams to detect or to resolve a complication in a simulated surgical scenario – was analyzed. Through recurrence quantification analysis, metrics of percent recurrence and communication determinism were calculated from the communications deemed to be indicative of the HRO principles. Conceptual recurrence metrics of accommodation, engagement, and leadership were also calculated through the software of Discursis based conceptual recurrence plots from the transcriptions of the procedures. A correlation coefficient analysis confirmed that the nature of the resolution for a complication – obvious or obscure – affected the communications. Three main conclusions can be made. First, surgical teams with communication indicative of commitment to resilience resolved the complications with obscure resolutions in less time. Second, surgical teams with communication indicative of deference to expertise – regardless of who spoke – resolved the complications with obvious resolutions in less time. Third, surgical teams exhibiting communication patterns with greater metrics of leadership resolved the complications with obvious resolutions in less time. In conclusion, during complications, surgical teams exhibiting communication indicative of the HRO principle of commitment of resilience during obscure resolutions, the principle of deference to expertise during obvious resolutions, and the conceptual recurrence metric of leadership during obvious resolutions are associated lower resolution times.