SAFETY CULTURE

Factors associated with surgeon's perception of distraction in the operating room

Published on

July 1, 2020

Surgical Endoscopy

James J Jung, Jonah Elfassy, Teodor Grantcharov
James J Jung, Jonah Elfassy, Teodor Grantcharov
James J Jung, Jonah Elfassy, Teodor Grantcharov

Overview

This study investigated factors contributing to surgeons feeling distracted during operations, a concern due to its potential impact on patient safety. Researchers analyzed 265 laparoscopic general surgeries using the OR Black Box® and surgeon surveys. They found that surgeons reported feeling distracted in 45% of operations, with various auditory and cognitive distractions present.

Multivariable analysis revealed two factors independently associated with increased likelihood of surgeons feeling distracted: irrelevant conversations in the operating room and patients having a history of previous abdominal surgery. The study concludes that irrelevant conversation is a modifiable factor that significantly contributes to surgeon distraction, suggesting a potential area for improvement in operating room practices to enhance patient safety.

Results

The attending surgeon reported feeling distracted in 120 of 265 operations (45%). Auditory sources of distraction, such as the OR door opening occurred at a median of 41 times per case (interquartile range (IQR), 32-54). Cognitive distractions such as teaching (142 cases (54%)), device malfunction (91 (34%)), irrelevant conversations (72 (27%)), management of the next case (41 (15%)), and time pressure (22 (8%)) occurred in a significant number of operations. In a multivariable analysis, presence of irrelevant conversations (odds ratio 2.14, 95% confidence interval (CI) 1.16-3.94, p = 0.015) and patient history of previous abdominal surgery (odds ratio 2.2, 95% CI 1.18-4.1, p = 0.013) were independently associated with increased likelihood of the surgeons feeling distracted.

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Copyright. All Rights Reserved 2024
Copyright. All Rights Reserved 2024