Background and Research Aims

 Research has found that surgical procedures in Australia suffer from a 22 per cent ‘adverse event rate’, while most of these events are minor and cause no permanent harm, 13 per cent of these events result in some form of permanent disability. In four per cent of cases errors may contribute to patients dying (less than 1% of all operations) but these tend to be in more complex and dangerous cases. Yet, disturbingly, almost half (48 per cent) of these ‘adverse events’ are preventable [i] and as many as 70 per cent are due to communication failures [ii].  Indeed, there is increasing evidence that surgical errors are not due to a lack of technical skills (e.g., training or knowledge), but are due to non-technical skills such as system, communication and team failures [iii].

The SWANS (Surgical Work-team Advanced Non-technical Skills) project is  rigorously examining the effectiveness of team briefings and debriefings in relation to important surgery-related outcomes. Key outcomes include: complication rates, procedure length, turnaround times, quality of communication and team performance.

This research project is ongoing.

How is this Research Being Conducted?

  • Observations of surgical procedures
  • Interviews with surgical teams
  • Questionnaires completed by surgical teams
  • Objective hospital data

Preliminary Findings

From the related six-month pilot study Joseph Carpini, a key researcher for the SWANS project and PhD candidate at the UWA Business School, found evidence that team briefings were an effective means of not only reducing medical error, but also increasing operating theatre efficiency. It is hoped that these findings will be confirmed as the SWANS project continues into another year-long study, which involves collaborating with Fiona Stanley Hospital.

Key Researchers:

Professor Sharon Parker
Joseph Carpini (PhD Candidate, UWA Business School) (
Prof Stewart Flemming (Professor, UWA School of Surgery)
Prof Jeffrey Hamdorf (Professor, UWA School of Surgery)




This research project is supported by the Social Sciences and Humanities Research Council of Canada.

[i] Kable, A. K., Gibberd, R. W., & Spigelman, A. D. (2002). Adverse events in surgical patients in Australia. International Journal for Quality in Health Care, 14(4), 269-276.
[ii] Leonard, M., Graham, S., & Bonacum, D. (2004). The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care, 13(suppl 1), i85-i90.
[iii] Hull, L., Arora, S., Aggarwal, R., Darzi, A., Vincent, C., & Sevdalis, N. (2012). The impact of nontechnical skills on technical performance in surgery: A systematic review. Journal of American College of Surgeons, 214(2), 214-230. doi: 10.1016/j.jamcollsurg.2011.10.016