A method for measuring work interference in surgical teams

To enhance surgical systems we need to manage the performance of the teams that comprise them. To do this we must measure the properties and processes of teams and account for the demands and conditions of their work. Recent research shows that observation is a potentially valuable method of measurement, but its potential application in surgery remains unclear. In this study of laparoscopic cholecystectomy, an observer applied observational measures of teamwork in the operating theatre and recorded intra-operative interference from observed distraction and interruption. Results showed that it was feasible to observe a broad scope of teamwork and to reveal the frequency and source of work interference. However, the measures were necessarily selective and so limited in their analysis of the conditions and events that might interfere with the collective work in surgery. Such measures may however prove useful when applied in conjunction with other methods of measurement and utilised as performance feedback data.

[1]  Ara Darzi,et al.  Observational Assessment of Surgical Teamwork: A Feasibility Study , 2006, World Journal of Surgery.

[2]  Eduardo Salas,et al.  Team Performance Assessment and Measurement: Theory, Methods, and Applications. Series in Applied Psychology. , 1997 .

[3]  J. Sexton,et al.  Error, stress, and teamwork in medicine and aviation: cross sectional surveys , 2000, BMJ : British Medical Journal.

[4]  S. Guerlain,et al.  A systems approach to surgical safety , 2002, Surgical Endoscopy And Other Interventional Techniques.

[5]  Jane Kidd,et al.  The effects of stress on surgical performance. , 2006, American journal of surgery.

[6]  J. Sexton,et al.  [Error, stress and teamwork in medicine and aviation. A cross-sectional study]. , 2000, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[7]  S Undre,et al.  Developing observational measures of performance in surgical teams , 2004, Quality and Safety in Health Care.

[8]  Brian Hazlehurst,et al.  Getting the right tools for the job: distributed planning in cardiac surgery , 2004, IEEE Transactions on Systems, Man, and Cybernetics - Part A: Systems and Humans.

[9]  Charles Vincent,et al.  Systems Approaches to Surgical Quality and Safety: From Concept to Measurement , 2004, Annals of surgery.

[10]  T. Brennan,et al.  INCIDENCE OF ADVERSE EVENTS AND NEGLIGENCE IN HOSPITALIZED PATIENTS , 2008 .

[11]  J. Reason,et al.  Human factors and cardiac surgery: a multicenter study. , 2000, The Journal of thoracic and cardiovascular surgery.

[12]  Paul Milgram,et al.  Planning behavior and its functional role in interactions with complex systems , 1997, IEEE Trans. Syst. Man Cybern. Part A.

[13]  R. Reznick,et al.  Communication failures in the operating room: an observational classification of recurrent types and effects , 2004, Quality and Safety in Health Care.

[14]  T. Brennan,et al.  Incidence of adverse events and negligence in hospitalized patients. , 1991, The New England journal of medicine.

[15]  Thomas B. Sheridan,et al.  Using field observations as a tool for discovery: analys ing cognitive and collaborative demands in the operating room , 2004, Cognition, Technology & Work.

[16]  T. Osler,et al.  Complications in surgical patients. , 2002, Archives of surgery.

[17]  A N Healey,et al.  The systems of surgery , 2007 .

[18]  R. Mcintyre,et al.  A Conceptual Framework for Teamwork Measurement , 1997 .

[19]  W. Cordell,et al.  Emergency department workplace interruptions: are emergency physicians "interrupt-driven" and "multitasking"? , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[20]  N. Sevdalis,et al.  Measuring intra-operative interference from distraction and interruption observedin the operating theatre , 2006, Ergonomics.

[21]  Matthew B. Weinger,et al.  Ergonomic and Human Factors Affecting Anesthetic Vigilance and Monitoring Performance in the Operating Room Environment , 1990, Anesthesiology.

[22]  Gudela Grote,et al.  Report on the psychological part of the project "The effects of different forms of coordination in coping with work load: Cockpit versus operating theatre" , 2004 .

[23]  K. Catchpole,et al.  Identification of systems failures in successful paediatric cardiac surgery , 2006, Ergonomics.

[24]  J. Sexton,et al.  Translating teamwork behaviours from aviation to healthcare: development of behavioural markers for neonatal resuscitation , 2004, Quality and Safety in Health Care.

[25]  Yan Xiao,et al.  Improving Operating Room Coordination: Communication Pattern Assessment , 2004, The Journal of nursing administration.

[26]  E. Salas,et al.  Understanding team performance: A multimethod study. , 1993 .

[27]  R. Helmreich On error management: lessons from aviation , 2000, BMJ : British Medical Journal.

[28]  Kunihide Sasou,et al.  Team errors: definition and taxonomy , 1999 .

[29]  M R de Leval,et al.  The human factor in cardiac surgery: errors and near misses in a high technology medical domain. , 2001, The Annals of thoracic surgery.

[30]  Matthew B. Weinger,et al.  A331 Naloxonazine blocks alfentanil-induced analgesia but not muscle rigidity in the rat , 1990 .

[31]  E. Salas,et al.  Promoting health care safety through training high reliability teams , 2005, Quality and Safety in Health Care.

[32]  Nick Sevdalis,et al.  Observational Teamwork Assessment for Surgery (OTAS): Refinement and Application in Urological Surgery , 2007, World Journal of Surgery.

[33]  M Koutantji,et al.  Quantifying distraction and interruption in urological surgery , 2007, Quality and Safety in Health Care.

[34]  S Undre,et al.  Defining the technical skills of teamwork in surgery , 2006, Quality and Safety in Health Care.

[35]  E. Etchells,et al.  Patient Safety in Surgery: Error Detection and Prevention , 2003, World journal of surgery.