ANESTHESIOLOGIST NAMES ON OUR HATS = A SOLID IDEA

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Physician anesthesiologist at Stanford at Associated Anesthesiologists Medical Group

Richard Novak, MD is a Stanford physician board certified in anesthesiology and internal medicine.Dr. Novak is an Adjunct Clinical Professor in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University, the Medical Director at Waverley Surgery Center in Palo Alto, California, and a member of the Associated Anesthesiologists Medical Group in Palo Alto, California.
emailrjnov@yahoo.com

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Personalized anesthesiologist headwear. Why not?

One of the career hazards for an anesthesiologist is being invisible. Early in my training I was warned not to become a locker slammer. That is, don’t be an anesthesiologist who arrives at the locker room, changes into scrubs, performs his or her anesthetics, and then retreats to the locker room at the end of the day to change back into street clothes, slam the locker, and disappear from the hospital. Locker slammers shun hospital committees, meetings, leadership opportunities, or intersections with medical society. It’s quite possible to earn a very lucrative living in anesthesia without interacting with the rest of the medical profession at all. In contrast, I’d suggest a more fulfilling career involves just the opposite, being part of the medical community in your hospital system.

One step in that direction is letting fellow professionals know who you are, and an initial step in this direction is wearing your name proudly while you’re at work.

The use of a medical professional’s name during operating room care leads to a better exchange of information, which results in more effective teamwork, and to improved patient care and safety. Knowing and recognizing team members by name has been associated with increased trust, work engagement, and improved clinical outcomes. Introduction by name and role is an integral part of the World Health Organization team brief, but it’s been shown that people only recall 30% of names after a first introduction.

In the operating room, we all wear identical unisex clothing. Our faces are covered with masks, and our heads are covered with hats. In a long surgery at a busy medical center, more than a dozen medical professionals—including surgeons, anesthesiologists, nurses, scrub techs, nurse anesthetists, and/or surgical reps—may be present during a single case. Individuals who aren’t scrubbed in may wear their hospital name tags which identify them both by name and by profession, but those who are scrubbed in are unable to wear and display their ID tags.

At the university hospital where I work, many residents wear hats identifying their name and their specialty, but at the private surgery centers where I work, no one does this. I believe this trend at the university hospital is driven by two forces: 1) youth, and 2) size of the institution. Younger physicians have embraced ID hats as part of their culture. The immense size of an academic medical center, where hundreds of doctors and hundreds of nurses work at all hours, night and day, presents an environment where it’s difficult to know one person from another, and it’s difficult to remember one person from another. Like snowflakes, no two healthcare professionals are exactly alike, and differentiating them by headgear is a valuable advance.

A team of Stanford obstetricians tested whether communication during Cesarean sections improved if everyone wore surgical hats labeled with their name and role. Their findings were published in The Joint Commission Journal on Quality and Patient Safety. They randomized 20 C-sections to have everyone wearing labeled or non-labeled surgical hats. Observers counted the use of names, and tracked what percentage of communications were missed. For example, if someone asked to have the operating table raised up and there was no response, that was recorded as a missed communication.

When labeled hats were used, more of the providers in surgery knew their colleagues’ names (77.8% vs. 55%) and roles (92.5% vs. 78.3%). Names were used more often—and fewer communications were missed—when everyone had labeled hats. People also commented that it was helpful to have labeled hats in emergency situations. Calling out someone’s name was the most direct way to get their attention. Patients also liked the hats. They said it decreased their anxiety, and it helped them understand who was in the room with them.

Doctors also piloted the use of labeled hats in the Stanford surgical simulator program. Participants found labeled hats helpful for improving communication during simulated crises.

Is there a downside to wearing hats with our names and roles written on them? Not really. There’s a small cost, and there’s a small burden to washing the hats periodically, but there is certainly no downside to patient care. I’ve found I like knowing who the other individuals are that I’m working with, particularly when there are personnel changes mid-case, or when I’m working with staff I’ve never met before. I like wearing the labeled hat myself, because I’d prefer that operating room staff know who I am rather than guessing or being afraid to ask me if they don’t know. Simply put, the benefit/risk ratio to wearing labeled hats is high. The improvement to the operating room culture is significant, particularly at a large facility where individuals don’t know each other very well and the potential for condescendingly being called “Hey, Anesthesia” instead of “Dr. Novak” is real.

If you don’t have an operating room hat with your name embroidered on it, consider buying one. There are multiple websites offering such personalized operating room headwear. Simply enter “embroidered operating room hats” into Google. If you work in operating room administration, consider purchasing labeled hats for your staff. In all probability, this one small change can improve camaraderie, morale, and even patient care. And purchasing a personalized hat as a holiday gift or a birthday present is a terrific way of honoring an employee, a colleague, or a friend.

Become better known. Be the best version of yourself in the operating room, and out of the operating room.

Wear your name.