Dr. Carol-anne Moulton was always fascinated by surgery. The bravery, confidence and culture of the profession was something she looked up to as a young medical trainee.
But once she came into that space for herself, she had a very different experience.
She quickly noticed how concerned surgeons were with their reputation and egos. Many expressed worries over how others would perceive them if they reached out for help too often, or admitted they didn't know something.
"I didn't feel all fearless and brave, and I wondered whether other people did," Dr. Moulton says.
"I could see they were scared but didn't want to say they were scared. I could see they might be wanting to call for help, but there was resistance to do that."
Realizing it was more than just a cognitive phenomenon, but the result of a very powerful culture, she decided to do something about it.
Now, as the first Surgical Lead for Cognition & Culture at UHN, Dr. Moulton's goal is to raise awareness about how the two are connected in the operating room (OR) and the effect that can have on both patient care and individual wellness. Part of her vision in calling attention to this topic is to establish a formal program or infrastructure to study such concepts and influence change – a vision she's currently seeing through.
Dr. Moulton believes that health care providers' individual wellness can be overlooked as they prioritize patient care, and part of the culture shift she aims to achieve includes working closely with frontline staff to better understand and address their needs.
"Any time you can create a better functioning team and a healthier, happier workforce, you'll have better patient care," she says. "If we can teach and encourage health care providers that it's better to get in touch with their human side rather than having to put on a front about who they are, I think that will be very good for our patients."
Dr. Thomas Forbes, Surgeon-in-Chief of UHN's Sprott Department of Surgery, says the impact individual attitudes and beliefs can have on the team environment is often under recognized in the operating room – including the effect that can have for the patient on the table.
While patients will always be a priority, staff need to be met with the same level of attention and care to achieve that goal, he says.
"Working in a healthy, constructive, respectful environment will certainly allow for more people to want to come to work at UHN, and to stay working for UHN," Dr. Forbes says.
Dr. Moulton's leadership has created the opportunity to continue respecting each other and listening more deeply, says Pam Hubley, Vice President of Health Disciplines and Chief Nurse Executive at UHN. This will enable staff to feel a greater sense of well-being in the OR, especially nurses.
"Nurses really want to feel connected," Pam says. "They want to feel like they're a part of that exceptional team.
"They show up every day to do their best work for patients and families, and these new ideas are going to push us to the next level of our abilities as teams, as care providers, as individuals who are really committed to creating the best environments to enable the best patient outcomes."
Dr. Moulton is an international leader in the scientific examination of cognition and culture and the unique benefits it can bring to the operating room. UHN is the first organization to take the lead on this.
"This is another example of the innovation that's being adopted at the University Health Network," says Dr. Forbes, emphasizing the opportunity to be the best in the world.
"We can be trailblazers in this area and really define the future of culture and cognition in the operating room, in the hospital, and in health care environments everywhere."