Validation of the Teamwork Perceptions Survey in the Operating Theatre

Background Teamwork is recognised as a vital factor in patient safety, and as such we need valid measurement tools to drive change. The aim of this study was to evaluate the validity of the Teamwork Perceptions Survey as a measure of staff perceptions of the functional and relational components of teamwork and leadership in the operating theatre. Methods The authors developed a 24-item questionnaire, aligned with the goals of a national team training intervention. The Teamwork Perceptions Survey was administered to New Zealand public hospital operating theatre staff before and after a hospital commencing the intervention. These scores were used to explore the psychometric properties of the tool, using Exploratory and Confirmatory Factor Analysis. Results 2409 (1233 pre- and 176 post-intervention respondents) completed the Teamwork Perceptions Survey. Exploratory factor analysis revealed 3 factors (6 items, communication and shared mental model; 6 items, leadership and role modelling; 5 items, trust and accountability) and resulted in dropping 5 redundant items. The final 17-item, three factor solution was confirmed by confirmatory factor analysis, revealing satisfactory goodness of fit. Cronbach’s alpha was high for the full survey ( α = 0.947), and each subscale (communication, α = 0.887; leadership, 6 items, α = 0.911; trust, α = 0.872). Conclusions These data provide evidence to support the validity and reliability of the Teamwork Perceptions Survey as a measure of staff perceptions of teamwork and leadership in the operating theatre. This new measurement tool for the functional and relational components of teamwork and leadership in the operating theatre has the potential for both measuring and driving quality improvement initiatives in teamwork and patient safety. Summary What is already known on this topic – Whilst there are a number of established teamwork measurement tools, many completed by an external observer, or do not adequately address the unique operating theatre environment. What this study adds – This study supports the validity and reliability of a new measure of staff perceptions of the functional and relational components of teamwork and leadership in the operating theatre. It fills a previous gap in available measures in that it is self-completed and is designed for the operating theatre environment. How this study might affect research, practice or policy – The Teamwork Perceptions Survey has the potential for both measuring and driving quality improvement initiatives in teamwork and patient safety in surgical practice.