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Problems concerning a particular setting

In the case of a particular setting, it is still important to feedback to the individuals involved, but a wider approach to tackling the issue can also be of benefit.

Situational issues often benefit from a multi-disciplinary and multi-level approach.  They may also be one part of a wider approach to improving departmental culture.


  1. See tips under Module 3, Question 4 "In handover" which include educational videos
  2. Multidisciplinary and multi-level handovers foster a collaborative culture, and help to reduce misunderstanding and misinformation- is there anyone else who should attend handover?
  3. Actively discourage common inadvertent incivilities such as deep sighs and eye-rolling
  4. Thank the departing team
  5. It is usually better to deliver feedback after handover, in private. However, there may be occasional times where the departing team have started an unwise or unsafe plan. Consider ways to address the management safely without undermining them. Phrases such as “Hindsight is a wonderful thing but I wonder if…” or “It sounds like you had an incredibly busy shift. I wonder if you had time to consider this option as an alternative given x…”
  6. Consider displaying which promote a civil and kind handover environment, Poster 5 "Handover" (PDF), Poster 2 "Tea" (PDF), Poster 1 "Sorry" (PDF)



  1. Issues are often best addressed collaboratively (multi-disciplinary and multi-level), proactively gaining feedback from all members of the team.
  2. Explain, acknowledge and agree that poor behaviour leads to increased complications and impaired team performance
  3. Can you use the pre and post list debrief to set the tone and enhance team working? eg discussing training needs of surgeons/anaesthetists/theatre team and which cases are suitable for training, setting realistic time limits so that any change to a senior person is done in a planned way rather than making the “junior” perceive that they have been replaced as they are not “performing well enough”.
  4. Support new team members with scrubbing, preparing patients and familiarise them with both  equipment and processes that are new to them and that the established team may take for granted. Remember team members who are new to the department or to the country will have other valuable skills but may not be familiar with local processes and the local team may underestimate their capabilities as a result. This can cause them to feel undervalued, under-confident and potentially less able to perform well.
  5. Consider displaying promoting teamwork and civility in theatre Poster 3 "Theatre" (PDF), Poster 2 "Tea" (PDF), Poster 1 "Sorry" (PDF)