Developing an observational tool for reliably identifying work system factors in the operating room that impact cardiac surgical care

Blocker, Renaldo C.; Eggman, Ashley A.; Zemple, Robert P.; Chi-Tao, Elise Wu; Wiegmann, Douglas A.

doi:10.1037/e578732012-016

Cited by 4 publications

(7 citation statements)

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“…Using a Tablet-PC data collection tool based on a previous version described elsewhere (Blocker et al, 2010); information about any event that disrupted the flow of the trauma care process was collected. Flow disruptions were time-stamped and categorized by observers in real time according to (1) type of flow disruption; (2) the potential and/or actual impact of the flow disruption on a scale from 1 to 5(1=no impact; 2=acknowledge/no delay; 3= momentary delay; 4=moderate delay; 5=full case cessation); (3) the trauma team member affected by the flow disruption; (4) the description of the flow disruption; and (5) the location of the observer.…”

Section: Methodsmentioning

confidence: 99%

Flow Disruptions in Trauma Surgery: Type, Impact, and Affect

Blocker

Duff

Wiegmann

et al. 2012

Proceedings of the Human Factors and Ergonomics Society Annual

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The objective of this study was to identify and understand all components of the trauma care process to mitigate the systemic challenges faced by clinicians attempting to deliver the best trauma care. The study was conducted using a prospective data collection method. An interdisciplinary team of researchers observed 87 cases over a 10-week period and identified 1759 flow disruptions. There were a higher number of flow disruptions per case in the operating room (M=61.3, ±36.72) than in the emergency department (M=9.2, ±1.77) or radiology (M=7.5, ±2.01). Focusing on the OR, the majority of the flow disruptions identified in the OR were due to either coordination issues (28%) or communication breakdowns (24%). Roughly 12% of disruptions resulted in moderate delays or full case cessation. This study demonstrates the value of using flow disruptions as a surrogate for efficiency and quality outcome measures, and as a diagnostic method for understanding higher order problems in the system of trauma care.

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Section: Methodsmentioning

confidence: 99%

Flow Disruptions in Trauma Surgery: Type, Impact, and Affect

Blocker

Duff

Wiegmann

et al. 2012

Proceedings of the Human Factors and Ergonomics Society Annual

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“…This methodology combines: (1) prospective observations using a Tablet-PC data collection tool for identifying non-routine events (Blocker, Eggman, Zemple, Wu, & Wiegmann, 2010), (2) audio and video recordings using a GoPro® Hero 3+ Camera, (3) pre-and post-surgery surveys, and (4) individual surgical team member interviews.…”

Section: Study Toolsmentioning

confidence: 99%

“…Timeline of the comprehensive methodology Table 1. Event categorization by type and impact (Blocker et al, 2010;Blocker et al, 2012;Parker et al, 2010) Type Definition Communication Any breach or lapse in team cooperativeness, cohesion, and/or familiarity as a result of verbal information exchanged (e.g. misunderstanding, communication unheard, case-related communication, extraneous conversation) Coordination Any breach or lapse in team cooperativeness, cohesion, and/or familiarity as a result of poor organization function (e.g.…”

Section: Obtaining Buy-inmentioning

confidence: 99%

“…Non-routine events (NREs), or surgical flow disruptions, have previously been linked to operative errors that occur during cardiac surgery (Wiegmann, ElBardissi, Dearani, Daly, & Sundt III, 2007). A validated, electronic Tablet-PC data collection tool was developed to identify NREs and has been generalized for use beyond the cardiac OR (Blocker et al, 2010). The tool has been used in prior studies to identify NREs and their impact on the natural progression of surgical cases and team functioning in the cardiac OR and emergency department (Blocker et al, 2012.…”

Section: Rationale For Electronic Data Collection Toolmentioning

confidence: 99%

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A Comprehensive Methodology for Examining the Impact of Surgical Team Briefings and Debriefings on Teamwork

Law

Hildebrand²,

Oliveira-Gomes

et al. 2014

Proceedings of the Human Factors and Ergonomics Society Annual

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The adoptions of briefing and debriefing protocols have evolved from the Joint Commission's initiative to improve communication and safety in the operating room. Briefing normally occurs prior to incision and is used to discuss and confirm critical information, while debriefing occurs during or after surgery. Debriefing provides a unique opportunity for individuals and teams to immediately reflect on their performance, allowing them to more easily identify errors and develop plans to improve their next performance. Studies have shown that using briefings and debriefings improve communication and teamwork. However, there is still much to learn about the value of both for surgical teams. This paper presents a robust methodology for examining and measuring the impacts of surgical team briefings and debriefings on teamwork. The methodology includes (1) audio/video recording the surgical care process, (2) prospective observations using a validated electronic data collection tool, (3) pre-and post-surgery surveys, and (4) individual surgical team member interviews. The current paper describes the methodology to obtain a robust and comprehensive data set for analyzing the impacts of briefing and debriefing on teamwork; the results of the surgeries recorded using this methodology will be presented in subsequent papers.

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“…Using the validated, tablet PC-based tool (Blocker, Eggman, Zemple, Chi-Tao, & Wiegmann, 2010) observers time-stamped and categorized interruptions by type, priority (i.e. low, medium, high), and location within the ED where the interruption occurred.…”

Section: Introductionmentioning

confidence: 99%

Do Trauma Activations Affect Interruptions in the Emergency Department?

Forsyth

Hawthorne

Lindén

et al. 2017

Proceedings of the Human Factors and Ergonomics Society Annual

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Clinicians have anecdotally indicated that interruptions increase following trauma activations in the emergency department (ED), yet it is unknown whether interruptions change following the end of a trauma case. This study aimed to examine the interruption characteristics of clinicians that participate in trauma activations before and after activations using the SEIPS model. Observers shadowed ED clinicians across entire shifts and logged interruptions that affected clinicians in a tablet PC-based tool. Interruption characteristics captured included duration, nature, location, and task priority. Trauma activations lasting more than five minutes were also recorded. Only interruptions occurring within one-hour of trauma activations were included in the analysis. Chi-square analyses identified significant associations between SEIPS-categorized interruptions and the interruption priority, p < 0.01, and between the SEIPS-categorized interruptions and the interruption location, p = 0.01, pre- and post-trauma activations. Identifying these associations revealed key opportunities to reduce unnecessary interruptions in the ED.

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Developing an observational tool for reliably identifying work system factors in the operating room that impact cardiac surgical care

Cited by 4 publications

References 0 publications

Flow Disruptions in Trauma Surgery: Type, Impact, and Affect

Flow Disruptions in Trauma Surgery: Type, Impact, and Affect

A Comprehensive Methodology for Examining the Impact of Surgical Team Briefings and Debriefings on Teamwork

Do Trauma Activations Affect Interruptions in the Emergency Department?

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