gms | German Medical Science

131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

The Observational Teamwork Assessment for Surgery (OTAS-D) in visceral and trauma surgery: Results for German speaking ORs

Meeting Abstract

  • Matthias Weigl - Klinikum der LMU München, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München
  • Stefanie Passauer-Baierl - Klinikum der LMU München, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, München
  • Christiane J. Bruns - Klinikum der LMU München, Klinik für Allgemeine, Viszeral-, Transplantations-, Gefäß- und Thoraxchirurgie, Campus Großhadern, München

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch286

doi: 10.3205/14dgch286, urn:nbn:de:0183-14dgch2862

Published: March 21, 2014

© 2014 Weigl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: Safe and effective surgical care in the operating room (OR) depends on the teamwork of the whole OR team. The tool ‘Observational Teamwork Assessment for Surgery (OTAS-D)’ is a method to determine the quality of interdisciplinary teamwork in the operating room. Similar to the English original tool it allows reliable evaluations on five core characteristics of successful surgical teamwork: Communication, Cooperation, Coordination, Leadership, Team monitoring, and Situational Awareness. These behaviors are rated for each of the three professional groups involved – surgeons, anaesthetists, and nurses – as well as for the pre-, intra- and postoperative phase.

The aim of our study was the systematic and standardized assessment of interdisciplinary teamwork in German speaking ORs based on the OTAS-D tool.

Material and methods: In two surgical clinics a total of N=63 observations were conducted (Mean duration 1h:23 min, SD 50:55min). Common visceral (52.4%) and orthopaedic/ trauma surgery procedures (31.7%) were included. Trained observers assessed OR teamwork based on the OTAS-D tool. The above mentioned characteristics for effective OR teamwork were rated on a scale from 0 ("Problematic behaviour: OR team function severely impaired") to 6 ("Exemplary behaviour : very highly effective in enhancing team function").

Results: The observation results showed overall a medium to good level of interprofessional teamwork in German ORs. Preoperatively, the surgeons received higher ratings ??in communication (M=3.76, SD=1.07) and cooperation (M=3.48, SD=.92), whereas the preoperative coordination was evaluated on a medium level (M=3.06, SD=.94). During the procedure, intra-operative leadership (M=3.79, SD=.85) and coordination (M=3.63, SD=.77) received higher evaluations. Team-monitoring during the operation was rated on a medium level (M=3.1, SD=.89). During the post-operative phase, all teamwork characteristics occurred to be significantly lower for surgical sub-team. Comparative analyses with the ratings of the nursing sub-team as well as with the anaesthetists enable insights into characteristics of effective interdisciplinary teamwork as well as needs for further improvement, e.g., pre-operative and post-operative coordination and communication.

Table 1 [Tab. 1]

Conclusion: Our study aimed to evaluate interdisciplinary surgical teamwork in German speaking ORs. We applied the OTAS-D for the first time to a large set of visceral and trauma procedures. Based on this standardized assessment our study provides information on characteristics that contribute to effective teamwork. The OTAS-D tool is suitable to identify strengths and deficits in interdisciplinary surgical teamwork: the results point to several needs for OR-team training (particularly with regard to preoperative and postoperative communication and coordination) as well as improvement in OR management (e.g., post-operative presence of surgeons in the OR). OTAS-D is feasible for further application in the areas of surgical safety, association to surgeons’ stress, and concomitant effects on the quality of surgical care.

Funding and Ethics: The study was supported by research and teaching fund of the Medical Faculty, Munich University (FöFoLe: #752). The study was approved by the Ethics Committee of Medical Faculty, Munich University.