Music in the Operating Room: Impact on Team Communication, Focus, and Monitoring Patient Safety.

Background Music is commonly played in the operating room (OR), yet excessive noise is a known contributor to miscommunication and surgical errors. This study examined how music choice and surgical phase influence surgical team members' perceptions of concentration, communication, and patient safety among OR staff. Methods A survey was administered via Research Electronic Data Capture (REDCap) in person, by email, and over Zoom to surgeons, nursing staff, and anesthesia providers. Questions addressed music preferences, who selects the music, and perceived effects during routine versus complex phases of surgery. Responses were analyzed by age and role using chi-squared tests. Results Response rate was 63.6%. Among 138 respondents (61 surgeons, 40 nursing staff, 37 anesthesia providers), 34.8% (n=48) preferred music at all times, and 10.9% (n=15) preferred none. Music preferences spanned 44 genres, five of which were commonly perceived as disruptive. Although 70.3% (n=97) reported mood benefits, 33% (n=37) reported impaired communication, 8% (n=11) impaired concentration, and 11.6% (n=16) impaired patient safety monitoring. Only 9.4% (n=12) of respondents selected the music; 75% (n=9) of these were attending surgeons (p<0.001), and most did not solicit team preferences. Two-thirds (66.2%; n=49) reported that music appropriateness depended on surgical phase, particularly during high-focus tasks such as counts. Conclusion While music is generally favored in the OR, it is centrally controlled and may negatively affect critical aspects of teamwork and safety. Greater awareness of surgical phase and shared decision-making around music selection may improve communication, team dynamics, and patient safety.