Surgical Improvement

Improve Surgical Culture

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Improve Surgical Culture

Good surgical outcomes depend on technical excellence, but a surgical team’s performance is also affected by the cognitive and inter-personal skills that team members bring to the job.

The attitudes, beliefs, and behaviours colleagues share with each other make up their collective culture – “the way we do things around here.” In surgery, culture influences how well we work together, how well we communicate with each other, our dedication to safety and, ultimately, how well we care for patients.

In 2012, a Surgical Quality Action Network initiative used the Safety Attitudes Questionnaire to measure safety culture in operating rooms. The survey was completed by staff in 70 acute care units across 14 BC hospitals and results showed significant gaps in the percentage of OR caregivers who reported “high” or “very high” levels of communication and collaboration with each other:

Additional studies have shown a relationship between surgical team culture and the rate of adverse events. Culture is also a major factor in change management, which means it can impact surgical departments’ engagement in improvement initiatives such as the surgical checklist and NSQIP.

Thankfully, positive shifts in workplace culture are linked to improved system-related and clinical outcomes, reduced adverse events and increased patient satisfaction. They also have tangible benefits for health care providers, teams and organizations by reducing work-related conflict and stress, fostering team communication to lessen harassment and bullying, and improving job satisfaction and perceptions of working conditions.1

Resources to Improve Your Surgical Team's Communication

Teamwork & Communication Action Series

We offer a free and interactive 13 week Action Series that focuses on skills and tools to improve teamwork and communication on your team. In the first two waves of the Action Series, nearly 90 teams have participated with over 600 total participants from across BC!

Learn more about the Series

Culture Change Toolbox

Our Culture Change Toolbox features 21 tools and interventions for changing culture, along with tips on how to apply them.

The toolbox outlines the steps that we can take to shift culture in health care: engaging people, setting foundations, assessing the current state, identifying and analyzing opportunities, choosing tools, and testing changes.

Download the Toolbox

How Well Does Your Team Communicate?

This three-minute video and companion guide help to address “the elephant in the room” and improve your group’s teamwork and communication.

After watching the video, use the guide to facilitate a debriefing conversation with your team. By engaging teams with a creative and non-clinical example, we hope to provide an opportunity to hone your observation skills and work to develop and improve how your team communicates.

Watch the video

Learn more about how to improve culture



  1. Braithwaite J, Herkes J, Ludlow K et al. Association between organizational and workplace cultures, and patient outcomes: systematic review. BMJ Open 2017; 7: 1-12