ABSTRACT
TOPplus is based on the principles of crew resource management (CRM). CRM training encompasses a wide range of knowledge, skills and attitudes including communication, situational awareness, problem solving, decision-making, and teamwork. TOPplus is designed to support team learning and engage the operating theatre (OT) team in doubleloop learning. Errors in OT can have serious consequences for patients and families but also for healthcare professionals themselves and the entire healthcare organization. Registration of TOPplus provides structured and reliable information on incidents as well as on communication and teamwork, which is an important condition to support error management. Most professionals received the development of TOPplus, introducing a time out and a debriefing in OT, as a very good initiative. Yet most teams in OT have had little team training and cannot rely on adequate work structures to improve effective teamwork and improve patient safety.
