Human factors, leadership, and communication are the top three contributors to unexpected events in a healthcare setting that kill or harm patients.

I turned the corner and there it was. The Death Star, as locals call it, because it’s star-shaped, imposing, and has a helipad on the roof. Also known as the Queen Elizabeth University Hospital in Glasgow—a state-of-the-art, 14-floor hospital completely interlinked, part of the National Health Service in Scotland—it was the site of the NOTSS Master Course I was invited to join.

In my exploration of what makes a good surgical team, I came across “Teamwork Assessment Tools in Modern Surgical Practice.” That article inspired me to write Can Surgery Teamwork Save Your Life?, describing one of the best assessments, Non-technical Skills for Surgeons (NOTSS).

Any excuse to travel is all right with me. So when the Royal College of Surgeons-Edinburgh offered a NOTSS Master course on a day I could be available, I headed to Glasgow for a few days of Scottish music, single malt scotch, and museums before the course.

Training surgeons in non-technical skills

NOTSS is a program to train surgical residents (and more senior physicians) in non-technical skills—the behavioral pieces of optimal surgical performance. Mr. Simon Paterson-Brown (UK surgeons who are accepted into the Royal College are called Mr, Miss, Ms, or Mrs rather than doctor) and Mr. Simon Gibson kicked off the day with the usual medical statistics about using checklists in the operating room, or theatre, as it’s known in the UK. Routine use of checklists halves surgical mortality, from 1.5% to 0.8%