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Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room
BACKGROUND: Studies in operating rooms (OR) show that minor disruptions tend to group together to result in serious adverse events such as surgical errors. Understanding the characteristics of these minor flow disruptions (FD) that impact major events is important in order to proactively design safe...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559781/ https://www.ncbi.nlm.nih.gov/pubmed/30158119 http://dx.doi.org/10.1136/bmjqs-2018-007957 |
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author | Joseph, Anjali Khoshkenar, Amin Taaffe, Kevin M Catchpole, Ken Machry, Herminia Bayramzadeh, Sara |
author_facet | Joseph, Anjali Khoshkenar, Amin Taaffe, Kevin M Catchpole, Ken Machry, Herminia Bayramzadeh, Sara |
author_sort | Joseph, Anjali |
collection | PubMed |
description | BACKGROUND: Studies in operating rooms (OR) show that minor disruptions tend to group together to result in serious adverse events such as surgical errors. Understanding the characteristics of these minor flow disruptions (FD) that impact major events is important in order to proactively design safer systems OBJECTIVE: The purpose of this study is to use a systems approach to investigate the aetiology of minor and major FDs in ORs in terms of the people involved, tasks performed and OR traffic, as well as the location of FDs and other environmental characteristics of the OR that may contribute to these disruptions. METHODS: Using direct observation and classification of FDs via video recordings of 28 surgical procedures, this study modelled the impact of a range of system factors—location of minor FDs, roles of staff members involved in FDs, type of staff activities as well as OR traffic-related factors—on major FDs in the OR. RESULTS: The rate of major FDs increases as the rate of minor FDs increases, especially in the context of equipment-related FDs, and specific physical locations in the OR. Circulating nurse-related minor FDs and minor FDs that took place in the transitional zone 2, near the foot of the surgical table, were also related to an increase in the rate of major FDs. This study also found that more major and minor FDs took place in the anaesthesia zone compared with all other OR zones. Layout-related disruptions comprised more than half of all observed FDs. CONCLUSION: Room design and layout issues may create barriers to task performance, potentially contributing to the escalation of FDs in the OR. |
format | Online Article Text |
id | pubmed-6559781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65597812019-06-26 Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room Joseph, Anjali Khoshkenar, Amin Taaffe, Kevin M Catchpole, Ken Machry, Herminia Bayramzadeh, Sara BMJ Qual Saf Original Research BACKGROUND: Studies in operating rooms (OR) show that minor disruptions tend to group together to result in serious adverse events such as surgical errors. Understanding the characteristics of these minor flow disruptions (FD) that impact major events is important in order to proactively design safer systems OBJECTIVE: The purpose of this study is to use a systems approach to investigate the aetiology of minor and major FDs in ORs in terms of the people involved, tasks performed and OR traffic, as well as the location of FDs and other environmental characteristics of the OR that may contribute to these disruptions. METHODS: Using direct observation and classification of FDs via video recordings of 28 surgical procedures, this study modelled the impact of a range of system factors—location of minor FDs, roles of staff members involved in FDs, type of staff activities as well as OR traffic-related factors—on major FDs in the OR. RESULTS: The rate of major FDs increases as the rate of minor FDs increases, especially in the context of equipment-related FDs, and specific physical locations in the OR. Circulating nurse-related minor FDs and minor FDs that took place in the transitional zone 2, near the foot of the surgical table, were also related to an increase in the rate of major FDs. This study also found that more major and minor FDs took place in the anaesthesia zone compared with all other OR zones. Layout-related disruptions comprised more than half of all observed FDs. CONCLUSION: Room design and layout issues may create barriers to task performance, potentially contributing to the escalation of FDs in the OR. BMJ Publishing Group 2019-04 2018-08-29 /pmc/articles/PMC6559781/ /pubmed/30158119 http://dx.doi.org/10.1136/bmjqs-2018-007957 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Joseph, Anjali Khoshkenar, Amin Taaffe, Kevin M Catchpole, Ken Machry, Herminia Bayramzadeh, Sara Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
title | Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
title_full | Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
title_fullStr | Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
title_full_unstemmed | Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
title_short | Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
title_sort | minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559781/ https://www.ncbi.nlm.nih.gov/pubmed/30158119 http://dx.doi.org/10.1136/bmjqs-2018-007957 |
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