Emotional intelligence in the operating room: Analysis from the Boston Marathon bombing


  • Beverly P. Chang, MD
  • Joshua C. Vacanti, MD
  • Yvonne Michaud, RN, MSN
  • Hugh Flanagan, MD
  • Richard D. Urman, MD, MBA




Boston Marathon bombing, emotional intelligence, operating room management, disaster management


Introduction: The Boston Marathon terrorist bombing that occurred on April 15, 2013 illustrates the importance of a cohesive, efficient management for the operating room and perioperative services. Conceptually, emotional intelligence (EI) is a form of social intelligence used by individuals in leadership positions to monitor the feelings and emotions of their team while implementing a strategic plan.

Objective: To describe the experience of caring for victims of the bombing at a large tertiary care center and provide examples demonstrating the importance of EI and its role in the management of patient flow and overall care.

Methods: A retrospective review of trauma data was performed. Data regarding patient flow, treatment types, treatment times, and outcomes were gathered from the hospital’s electronic tracking system and subsequently analyzed. Analyses were performed to aggregate the data, identify trends, and describe the medical care.

Results: Immediately following the bombing, a total of 35 patients were brought to the emergency department (ED) with injuries requiring immediate medical attention. 10 of these patients went directly to the operating room on arrival to the hospital. The first victim was in an operating room within 21 minutes after arrival to the ED.

Conclusion: The application of EI in managerial decisions helped to ensure smooth transitions for victims throughout all stages of their perioperative care. EI provided the fundamental groundwork that allowed the operating room manager and nurse leaders to establish the calm and coordinated leadership that facilitated patient care and teamwork. 


Author Biographies

Beverly P. Chang, MD

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

Joshua C. Vacanti, MD

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

Yvonne Michaud, RN, MSN

Trauma and Burn Program, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

Hugh Flanagan, MD

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

Richard D. Urman, MD, MBA

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.


Gawande A: Why Boston’s hospitals were ready. The New Yorker. Available at http://www.newyorker.com/online/blogs/newsdesk/2013/04/why-bostons-hospitals-were-ready.html. Accessed April 29, 2014.

Goleman D, Bovatzis R, McKee A: Primal Leadership: Unleashing the Power of Emotional Intelligence. Boston, MA: Harvard Business School Press, 2013.

Salovey P, Mayer JD: Emotional intelligence. Imagin Cogn Pers. 1990: 185-211.

Bar-On R: The Bar-On model of emotional-social intelligence. Psicothema. 2006; 18(suppl.): 13-25.

Musumeci R, Kaye AD, Fox CJ, et al.: The path to successful operating room environment. In Kaye AD, CJ Fox, Urman RD (eds.): Operating Room Leadership and Management. New York, NY: Cambridge University Press, 2012: 15-24.

Brief AP, Weiss HM: Organizational behavior: Affect in the workplace. Annu Rev Psychol. 2002; 53: 279-307.

Tessema D, Alemu B: Emotional intelligence and transformational leadership for organizational development. Paper presented at the Academy of Management (AOM) Annual Meeting, San Antonio, TX, 2011:1-34.

George JM: Emotions and leadership: The role of emotional intelligence. Hum Relat. 2000; 53(8): 1027-1055.

Ashkanasy NM, Dasborough MT: Emotional awareness and emotional intelligence in leadership teaching. J Educ Bus. 2003; 79: 18-22.

Lobas JG: Leadership in academic medicine: Capabilities and conditions for organizational success. Am J Med. 2006; 119(7): 617-621.

McCallin A, Bamford A: Interdisciplinary teamwork: Is the influence of emotional intelligence fully appreciated? J Nurs Manag. 2007; 15(4): 386-391.

Quoidbach J, Hansenne M: The impact of trait emotional intelligence on nursing team performance and cohesiveness. J Prof Nurs. 2009; 25(1): 23-29.

Herbert R, Edgar L: Emotional intelligence: A primal dimension of nursing leadership? Nurs Leadersh (Tor Ont). 2004; 17(4): 56-63.

Akerjordet K, Severinsson E: Emotionally intelligent nurse leadership: A literature review study. J Nurs Manag. 2008; 16(5): 565-577.

Rahim M, Psenicka C, Polychroniou P, et al.: Emotional intelligence and transformational leadership: a group level analysis in five countries. Curr Top Manag. 2006; 11: 223-236.

Erkutlu H, Chafra J: The impact of team empowerment on proactivity: The moderating roles of leader’s emotional intelligence and proactive personality. J Health Org Manag. 2012; 26(4-5): 560-577.

Shamir B, House RJ, Arthur MB: The motivational effects of charismatic leadership: A self-concept based theory. Org Sci. 1993; 4: 577-593.

Arora S, Ashrafian H, Davis R, et al.: Emotional intelligence in medicine: A systematic review through the context of the ACGME competencies. Med Educ. 2010; 44(8): 749-764.

Grewal D, Davidson HA: Emotional intelligence and graduate medical education. JAMA. 2008; 300(10): 1200-1202.

Levinson W, Roter DL, Mullooly JP, et al.: Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997; 277(7): 553-559.

Codier E, Kooker BM, Shoultz J: Measuring the emotional intelligence of clinical staff nurses: An approach for improving the clinical care environment. Nurs Adm Q. 2008; 32(1): 8-14.

Webb AR, Young RA, Baumer JG: Emotional intelligence and the ACGME competencies. J Grad Med Educ. 2010; 2(4): 508-512.

Harms P, Crede M: Emotional intelligence and transformational and transactional leadership: A meta-analysis. J Leadersh Org Stud. 2010; 17: 5-17.

Pearson A, Laschinger H, Porritt K, et al.: Comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in healthcare. Int J Evid Based Healthc. 2007; 5(2): 208-253.

Prati L, Douglas C, Ferris G, et al.: Emotional intelligence, leadership effectiveness and team outcomes. Int J Org Anal. 2003; 11: 21-40.

Van Rooy DL, Viswesvaran C: Emotional intelligence: A metaanalytic investigation of predictive validity and nomological net. J Vocat Behav. 2004; 65: 71-95.

Van Velsor E, Leslie JB: Why executives derail: Perspective across time and cultures. Acad Manage Exec. 1995; 9: 62-72.

Cherniss C, Extein M, Goleman D, et al.: Emotional intelligence: What does the research really indicate? Educ Psychol. 2006; 41(4): 239-245.



How to Cite

Chang, MD, B. P., J. C. Vacanti, MD, Y. Michaud, RN, MSN, H. Flanagan, MD, and R. D. Urman, MD, MBA. “Emotional Intelligence in the Operating Room: Analysis from the Boston Marathon Bombing”. American Journal of Disaster Medicine, vol. 9, no. 2, Apr. 2014, pp. 77-85, doi:10.5055/ajdm.2014.0144.




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