Poorly behaved Australian surgeons are officially on watch ... sort of.
Unexplained images of eyes attached to the walls of an Adelaide orthopaedic hospital has markedly reduced poor behaviour among surgical teams.
The novel experiment - the design of University of South Australia researchers - hoped to address a widespread culture of bullying and offensive and poor behaviour in operating theatres.
The impact was marked.
Researchers asked 74 staff at a private hospital – including surgeons, trainees, nurses, anaesthetists and technicians – to report incidents of bad behaviour in the operating theatre.
A month later, the eye signs were placed.
Seven weeks later, a follow-up survey showed a marked drop in offensive and rude remarks, particularly those experienced by theatre nurses.
Lead researcher Professor Cheri Ostroff attributed the result to a perception of being "watched", even though the eyes were not real.
So-called "incivility" is prevalent in many industries, including the healthcare sector and particularly in high-stress and high-pressure environments such as operating theatres.
"Teamwork is critical during surgery," Prof Ostroff said.
"When incivility contributes to poor communication in the operating theatre, worse outcomes can result."
The consequences are far reaching, leading to high staff turnover, low job satisfaction, a drop in productivity and less compliance with infection control and medication protocols.
Surgeon Nicholas Wallwork, who took part in the study, said the experiment showed if people perceived they were being watched, they would change their behaviour, even subconsciously.
"Rudeness and bullying occur in operating theatres because the stakes are high," he said.
"There are at least six people working as a team in a confined space, under time pressures and with risks involved.
"A high-functioning stable team delivers better performance, but due to numerous factors this is sometimes difficult to achieve."
Dr Wallwork said poor communication was a recognised problem in the industry and it could come from the top down and across teams.
Complex leadership structures, where surgeons have direct clinical control of staff during a shift, but are not line managers outside the operating theatre, lead to conflict, he said.
"Unless we change this structure, which is leading to high burnout and frequent staff turnover, we will face a crisis in the industry."
The team's findings have been published in the peer-reviewed open access journal Plos One.
