Developing social capital in the operating room: the use of population-based techniques.

FUNCTIONAL relationships improve communities. An overall indicator of the quality of the relationships within a community is the century-old concept of social capital. Social capital has been defined as “those features of social structures—such as interpersonal trust and norms of reciprocity and mutual aid–which act as resources for individuals and facilitate collective action.” Social capital builds successful communities via robust relationships that develop from and create the interpersonal resources. Just as material capital produces more wealth, social capital lubricates interpersonal interactions and enables cooperative ventures, leading to better schools, decreased violent crime, decreased pugnacity, increased public health, and decreased mortality. Social capital within a group, known as bonding social capital, promotes reciprocity and underpins identity and homogeneity, but may exclude or harm those outside of the group. In the operating room community, such a group may be defined as all of the anesthesiologists, or it may be defined as the doctors, nurses, and technicians of the liver transplant team. Bridging social capital, on the other hand, occurs between groups, such as between surgeons and anesthesiologists, between physicians and nurses, or between clinicians and administrators. Bridging social capital promotes information exchange and generates broader identification and reciprocity. Social capital may help or hurt a community. For example, a subgroup of a community can have considerable social capital as they work together to thwart the majority. In this article, social capital refers to the positive aspects of both bonding and bridging social capital among the entire operating room community.