The relationship of the emotional climate of work and threat to patient outcome in a high-volume thoracic surgery operating room team.

Context: It is widely believed that the emotional climate of surgical team's work may affect patient outcome.

Objective: To analyse the relationship between the emotional climate of work and indices of threat to patient outcome.

Design: Interventional study.

Setting: Operating rooms in a high-volume thoracic surgery centre from September 2007 to June 2008.

Participants: Thoracic surgery operating room teams.

Intervention: Two 90 min team-skills training sessions focused on findings from a standardised safety-culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication and leadership.

Main Outcome Measures: Relationship of functional or less functional emotional climates of work to indices of threat to patient outcome.

Results: A less functional emotional climate corresponded to more threat to outcome in the sterile surgical environment in the pre-intervention period (p<0.05), but not in the post-intervention or sustaining period of this study. This relationship did not exist in the anaesthesia or circulating environments of the operating room.

Conclusions: The emotional climate of work in the sterile surgical environment appeared to be related to threat to patient outcome prior to, but not after, a team-training intervention. Further study of the relationship between the emotional climate of work and threat to patient outcome using reproducible methods is required.