Communication in the operating room is enhanced by knowing everyone’s names and roles. This is challenging among different disciplines.1 Name badges can be small, flipped, and concealed by personal protective equipment. A labeled scrub cap may make name and role more readable from a distance (fig.). Role clarity and addressing individuals by name enhance communication, teamwork, and patient safety.2 Role clarity may also promote diversity, equity, and inclusion. For example, women were 20% less likely to be thought of as surgeons by patients.3 In an anesthesiology care team model, role confusion can sometimes be misleading to patients and medical professionals.
At our hospital, each team member received several labeled caps to allow for laundering and a clean cap to be worn in the perioperative area. Although there was previous concern regarding head coverings and infection risk, multiple organizations, including the American Society of Anesthesiologists (Schaumburg, Illinois), The Joint Commission (Oakbrook Terrace, Illinois), and surgical and nursing societies, have concluded that there is no association between surgical cap type and surgical site infection.4 Each interprofessional group designated its preferred notation. Physicians chose “Doctor” with full name, whereas nurses preferred “RN” with first name.
Individuals have put names on their surgical caps for years. Institutional sponsorship supporting the majority of providers wearing labeled caps represents a culture change enhancing effective team communication. Widespread use of low-cost caps with clearly identifiable names and roles may improve communication, role clarity, provider well-being, and diversity, equity, and inclusion while enhancing patient safety and not increasing risk of surgical site infection.
Acknowledgments
The authors thank Ling Chen, M.S.N., R.N., C.N.O.R. (Interventional Platform Education, Stanford, California), Teresa Roman-Micek, B.S., C.H.S.O.S. (Interventional Platform Education), and Katherine Field, B.A. (Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California), for their tireless work. They also thank Stanford Hospital and Clinics and the Departments of General Surgery and Anesthesiology, Perioperative and Pain Medicine, for their support in widespread adoption of labeled surgical caps. Photo credit: Chad Howard, R.N., Palo Alto, California.
Competing Interests
Dr. Goldhaber-Fiebert received an honorarium from the Korean Society of Anesthesiologists (Seoul, Korea) for a talk presented virtually at KoreAnesthesia 2021, which took place in Busan, Korea. She has also received a grant from the Anesthesia Patient Safety Foundation (Rochester, Minnesota). The other authors declare no competing interests.