'Eye' signages reduce offensive, rude behaviour in operating theatres

Research shows how 'simple intervention' impacted behaviour in medical workplace

'Eye' signages reduce offensive, rude behaviour in operating theatres

Researchers from Australia have reduced offensive and rude comments in operating theatres thanks to new "eye" signages that "monitored" employees in a new study aimed at preventing bad behaviour in the workplace.

The research, led by University of South Australia Professor Cheri Ostroff, saw the participation of 74 staff at a private orthopaedic hospital in Adelaide. It included surgeons, trainees, nurses, anaesthetists, and technicians.

Under the experiment, participants were requested to report cases of bad behaviour in the operating theatre.

A month later, eye images were attached as signages to the wall of the hospital's operating theatre without any explanation, followed by another survey among the participants seven weeks later.

"The simple intervention of placing 'eye' signs in the theatre areas had a significant impact on reducing incivility events, particularly for theatre scrub nurses," the report said.

According to the report, given that the respondents were unaware of the signages' purpose, this suggests that the impact was "largely unconscious in modifying behaviour."

"This is consistent with the premises in prior work demonstrating that monitored observation alters behaviour in socially desirable ways, with the effect so strong that even depictions of eyes can unconsciously evoke a sense of being observed," the report said.

Addressing bullying at work

The experiment was carried out in a bid to address the culture of bullying and poor behaviour in surgical theatres, according to the research.

Citing other studies, it said majority of healthcare workers have reported experiencing events characterised by incivility, such as rudeness, derision, insulting remarks, humiliation, or ignoring someone.

And this in turn, impacts employee well-being, according to the research, noting that it could lead to high staff turnover, low job satisfaction, as well as a drop in productivity.

"Teamwork is critical during surgery. When incivility contributes to poor communication in the operating theatre, worse outcomes can result," Ostroff said in a statement.

Dr. Nicholas Wallwork, who participated in the study, said rudeness and bullying occur in operating theatres because the stakes are high.

"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," Wallwork said in a statement.

"Poor communication is a recognised problem in our industry, and it is not always from the top down, but across teams."

How simple interventions helps

The findings of the research indicate that poor behaviour in the workplace can be modified using simple interventions, according to Ostroff.

"Changing the workplace culture is important. In many healthcare settings, management are far removed from the day-to-day workplace stressors, creating a disconnect and lack of understanding," she said.

However, the study noted that the effect of the "eye" signs will last long.

"Thus, it should be viewed as one component of a larger program to address and reduce incivility and additional interventions should be explored to complement and extend the findings for longer-term culture change," the study said.

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