From diagnosis to discharge, surgical care involves multiple key teams. While fundamentally interconnected, these teams often operate in relative isolation from one another, focusing on their specific responsibilities before passing the baton to the next group. In this blog post, we’ll explore how this fragmented approach both reflects and perpetuates the formation of silos, and how these silos can affect the quality and efficiency of perioperative care. We’ll also share some practical strategies to help break down barriers, foster collaboration, and leverage our collective strengths to achieve the highest standards of care.
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If you’ve ever worked in an organization, you’ve probably come across the term “silos.†It’s become such a buzzword that it’s even made its way into the Forbes list of annoying business jargon. But beyond the clichés, silos represent a very real issue: when departments or teams fail to communicate effectively, inefficiencies creep in, and mistakes can happen.
Consider the surgical world. Surgeons, anesthesiologists, surgical technicians, and recovery staff often work in their respective bubbles, rarely stepping outside their comfort zones to collaborate. Over time, this leads to entrenched behaviors that prioritize the goals of the team over the bigger picture. For example, surgical techs might focus solely on sterilization without considering the downstream impact on the OR schedule. Or anesthesiologists may overlook the importance of communicating with recovery staff during handoffs. These silos not only hinder communication but also create unnecessary redundancies and delays.
Gillian Tett, in her book *The Silo Effect*, offers a broader perspective on this phenomenon. She argues that silos are a form of systemic fragmentation, where teams function like competing tribes, each with its own objectives, language, and culture. While this division helps streamline operations, it can also lead to missed opportunities for innovation and improvement. As Tett notes, “the modern world needs silos,†but the key is mastering them—not letting them master us.
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One area particularly prone to silos is the intraoperative phase of surgery, which takes place in the operating room (OR). This is where the action happens, and it’s also where multiple teams converge. The OR is a complex environment, with surgeons, anesthesiologists, nurses, and technicians working in parallel. Each team follows its own protocols, often unaware of—or unconcerned with—the workflows of others.
Research has shown that communication breakdowns in the OR are alarmingly common. A study from the University of Toronto revealed that communication failures occurred in 30% of team exchanges, with one-third of these incidents jeopardizing patient safety. Similarly, in Washington state, communication failures accounted for 43% of perioperative anesthesia malpractice claims, many of which happened during the intraoperative period. The majority of these failures occurred between anesthesiologists and surgical teams, two groups that often operate in isolation.
Beyond direct harm, these silos also contribute to inefficiency. Researchers in Chicago observed 67 communication failures in the OR during a 150-hour observation period. Thirty-six percent of these failures were related to equipment issues, while 24% involved a lack of updates about the operation’s progress. These lapses often resulted in delays, wasted time, and frustrated staff.
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So, how do we bridge these gaps? One promising solution lies in breaking down data silos. In surgery, where access to timely and accurate information is critical, isolating data can be counterproductive. Initiatives like Integrated Care Pathways, Enhanced Recovery After Surgery (ERAS), and the Perioperative Surgical Home have demonstrated significant improvements in outcomes by promoting transparency and resource sharing. By pooling data and resources, teams can better coordinate efforts and improve overall efficiency.
At Incision, we’ve developed tools like the *Universal Surgical Language* to address these challenges. This framework standardizes surgical procedures and concepts, reducing errors and enhancing performance. Through our online academy, which offers over 750 courses filmed live in the OR, we’ve empowered surgeons worldwide to adopt best practices and communicate more effectively. Our platform is accredited by the Royal College of Surgeons of England and currently serves over 170,000 users globally.
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On the ground, fostering cross-team connectivity requires innovative solutions. Mobile apps like *Incision Assist* are revolutionizing how surgical teams interact. With features tailored to specific units, teams, and surgeons, Assist ensures everyone has instant access to relevant protocols and resources. Whether it’s checking equipment readiness in the pre-op bay or reviewing post-op instructions in recovery, Assist streamlines communication and reduces friction.
Imagine this scenario: In the holding area, the pre-op team opens Assist to confirm everything is set for anesthesia, including the video-guided system preferred by the anesthesiologist. Meanwhile, the OR is prepared exactly as the surgeon prefers, thanks to detailed maps available in the app. The surgery starts on time, with no confusion over equipment. Midway through, recovery staff consults the app to clarify drain placement. Later, in recovery, the surgeon’s post-op instructions are clear and easily accessible, regardless of who’s reading them.
By leveraging technology to connect our silos, we’re not eliminating divisions but enhancing collaboration. This shift empowers us to work smarter, not harder, and ultimately deliver better care to our patients. Join us in this conversation—follow Incision on LinkedIn, Twitter, or Facebook to stay updated on the latest developments in surgical innovation.
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Breaking down silos isn’t about tearing down walls but building bridges. It’s about embracing diversity of thought, fostering open dialogue, and learning from each other. Together, we can transform the surgical landscape, ensuring safer, more efficient care for everyone involved.
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