Dual surgeon operating to improve patient safety

Ellis, Ricky; Hardie, J.A.; Summerton, Duncan J.; Brennan, Peter A.

doi:10.1016/j.bjoms.2021.02.014

Cited by 12 publications

(18 citation statements)

References 19 publications

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“…In this phase, health-care institutions were also given time to implement new safety procedures such as infection control and early discharge; improve clinician awareness, use virtual appointments to minimize exposure, and prepare to manage COVID-19 patient volumes while maintaining access to urgent and nonurgent surgeries. [17][18][19][20] The third phase of the pandemic occurred with the onset of the second COVID-19 patient volumes wave on October 19, 2020. 21 Starting from this date and throughout 2021, COVID-19 patient volumes reached new heights that were nearly quadruple the size of the first wave; however, wait time for surgery remained similar to pre-COVID-19 levels for urgent and nonurgent, cancer, and noncancer diagnosis groups.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Access to Cancer Surgery: Analysis of Surgical Wait Times in British Columbia, Canada

Shojaei,

Bakos,

Loree

et al. 2023

Disaster med. public health prep.

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Objective: As coronavirus disease 2019 (COVID-19) spread, efforts were made to preserve resources for the anticipated surge of COVID-19 patients in British Columbia, Canada. However, the relationship between COVID-19 hospitalizations and access to cancer surgery is unclear. In this project, we analyze the impact of COVID-19 patient volumes on wait time for cancer surgery. Methods: We conducted a retrospective study using population-based datasets of regional surgical wait times and COVID-19 patient volumes. Weekly median wait times for urgent, nonurgent, cancer, and noncancer surgeries, and maximum volumes of hospitalized patients with COVID-19 were studied. The results were qualitatively analyzed. Results: A sustained association between weekly median wait time for priority and other cancer surgeries and increase hospital COVID-19 patient volumes was not qualitatively discernable. In response to the first phase of COVID-19 patient volumes, relative to pre-COVID-19 pandemic levels, wait time were shortened for urgent cancer surgery but increased for nonurgent surgeries. During the second phase, for all diagnostic groups, wait times returned to pre-COVID-19 pandemic levels. During the third phase, wait times for all surgeries increased. Conclusion: Cancer surgery access may have been influenced by other factors, such as policy directives and local resource issues, independent of hospitalized COVID-19 patient volumes. The initial access limitations gradually improved with provincial and institutional resilience, and vaccine rollout.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Access to Cancer Surgery: Analysis of Surgical Wait Times in British Columbia, Canada

Shojaei,

Bakos,

Loree

et al. 2023

Disaster med. public health prep.

View full text Add to dashboard Cite

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“…They would also be able to observe and gain a series of non-technical skills (communication, teamwork, leadership, etc), as well as learning the rationale behind certain intra-operative decisions. 11…”

Section: Discussionmentioning

confidence: 99%

“…Local departments need to have the capacity and willingness to embrace such changes, with plans on how best to optimise theatre time. 11 This may have a negative impact on time provided for other services such as endoscopy and clinics. Associated financial costs must be considered and weighed against the clinical benefits of dual surgeon operating in relation to clinical outcome, surgeon confidence and wellbeing.…”

Section: Discussionmentioning

confidence: 99%

Do we need a co-pilot in the operating theatre? A cross-sectional study on surgeons’ perceptions

Taribagil,

Liu,

Bhattacharya

et al. 2023

Scott Med J

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Objective The aim of this original study was to investigate general surgeons’ perceptions on the role of dual surgeon operating for high-risk, elective complex surgical procedures. Material and Methods A 21-part cross-sectional online survey was self-completed by 85 general surgeons across hospitals in the UK. The survey assessed the perception of dual surgeon operating on patient morbidity and mortality, surgeons’ burnout rates, complaints, patient waiting times and overall trainee experience. Statistical analysis was performed using R version 3.6.1. Results Overall 78.8% believed that dual surgeon operating could help to overcome these human factors. Sub-analysis includes improve surgeon fatigue (89.4%), improve confidence (83.5%), improve decision-making (76.5%), minimise technical error (69.4%), improve communication, team work and leadership skills (65.9%). 65.9% believed it would reduce surgeons’ burnout. There was a statistically significant relationship between the participants believing it would reduce surgeons’ burnout and those who felt it would reduce complaints, Chi-squared(4) = [30.8], p = [0.00000342]. A statistically significant relationship was noted between participants believing it would reduce surgeons’ burnout and those who felt it would reduce patient mortality/morbidity, Chi-squared(4) = [19.9], p = [0.000517]. Conclusion The survey has highlighted positive surgeons’ perceptions regarding dual surgeon operating.

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“…One trainer described 'compartmentalising' operative cases (seizing and reconfiguring): "It is a strange thing to do is to split an operation up because it's not how I was trained, you know, but it's probably the right thing to do [with respect to providing maximum training opportunities] to split an operation up between trainees" (TR16). Because of the added burden of COVID-19 to "the complexity of patients" (TR11) (sensing), one vascular surgical department "instituted a two-consultant operating model" (TR11) (seizing) (Ellis et al, 2021). This service delivery model was deemed conducive to training so rotas were altered to regularly pair trainees with trainers (reconfiguring): "I've got feedback from the trainees that this is excellent.…”

Section: Training Opportunitiesmentioning

confidence: 99%

“It’s making me think outside the box at times”: a qualitative study of dynamic capabilities in surgical training

Shah

Walker

et al. 2022

Adv in Health Sci Educ

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Craft specialties such as surgery endured widespread disruption to postgraduate education and training during the pandemic. Despite the expansive literature on rapid adaptations and innovations, generalisability of these descriptions is limited by scarce use of theory-driven methods. In this research, we explored UK surgical trainees’ (n = 46) and consultant surgeons’ (trainers, n = 25) perceptions of how learning in clinical environments changed during a time of extreme uncertainty (2020/2021). Our ultimate goal was to identify new ideas that could shape post-pandemic surgical training. We conducted semi-structured virtual interviews with participants from a range of working/training environments across thirteen Health Boards in Scotland. Initial analysis of interview transcripts was inductive. Dynamic capabilities theory (how effectively an organisation uses its resources to respond to environmental changes) and its micro-foundations (sensing, seizing, reconfiguring) were used for subsequent theory-driven analysis. Findings demonstrate that surgical training responded dynamically and adapted to external and internal environmental uncertainty. Sensing threats and opportunities in the clinical environment prompted trainers’ institutions to seize new ways of working. Learners gained from reconfigured training opportunities (e.g., splitting operative cases between trainees), pan-surgical working (e.g., broader surgical exposure), redeployment (e.g., to medical specialties), collaborative working (working with new colleagues and in new ways) and supervision (shifting to online supervision). Our data foreground the human resource and structural reconfigurations, and technological innovations that effectively maintained surgical training during the pandemic, albeit in different ways. These adaptations and innovations could provide the foundations for enhancing surgical education and training in the post-pandemic era.

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Dual surgeon operating to improve patient safety

Cited by 12 publications

References 19 publications

Impact of the COVID-19 Pandemic on Access to Cancer Surgery: Analysis of Surgical Wait Times in British Columbia, Canada

Impact of the COVID-19 Pandemic on Access to Cancer Surgery: Analysis of Surgical Wait Times in British Columbia, Canada

Do we need a co-pilot in the operating theatre? A cross-sectional study on surgeons’ perceptions

“It’s making me think outside the box at times”: a qualitative study of dynamic capabilities in surgical training

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