Exploring human factors in the operating room: scoping review of training offerings for healthcare professionals

Abstract

Background Human factors (HF) integration can improve patient safety in the operating room (OR), but the depth of current knowledge remains unknown. This study aimed to explore the content of HF training for the operative environment. Methods We searched six bibliographic databases for studies describing HF interventions for the OR. Skills taught were classified using the Chartered Institute of Ergonomics and Human Factors (CIEHF) framework, consisting of 67 knowledge areas belonging to five categories: psychology; people and systems; methods and tools; anatomy and physiology; and work environment. Results Of 1851 results, 28 studies were included, representing 27 unique interventions. HF training was mostly delivered to interdisciplinary groups (n = 19; 70 per cent) of surgeons (n = 16; 59 per cent), nurses (n = 15; 56 per cent), and postgraduate surgical trainees (n = 11; 41 per cent). Interactive methods (multimedia, simulation) were used for teaching in all studies. Of the CIEHF knowledge areas, all 27 interventions taught ‘behaviours and attitudes’ (psychology) and ‘team work’ (people and systems). Other skills included ‘communication’ (n = 25; 93 per cent), ‘situation awareness’ (n = 23; 85 per cent), and ‘leadership’ (n = 20; 74 per cent). Anatomy and physiology were taught by one intervention, while none taught knowledge areas under work environment. Conclusion Expanding HF education requires a broader inclusion of the entirety of sociotechnical factors such as contributions of the work environment, technology, and broader organizational culture on OR safety to a wider range of stakeholders.

Guideline for Team Communication

“…“The interactions between everyone on the perioperative team have a positive or negative effect on team members’ psychological safety,” she said. “Health care leaders can create an environment that promotes professional respect by supporting multidisciplinary team training, incorporating feedback into policies, minimizing power imbalances, and providing system support.” A revised recommendation was added that these same leaders should provide a safe platform that staff members can use to report near misses, errors, hazardous conditions, and threatening actions 1,2 . Health care leaders provide the foundation for building a culture of safety, partly because they are role models and can encourage staff members to act in a way that improves safety; however, these efforts can be weakened by allowing unsafe behaviors to continue 3 …”

“…A revised recommendation was added that these same leaders should provide a safe platform that staff members can use to report near misses, errors, hazardous conditions, and threatening actions. 1,2 Health care leaders provide the foundation for building a culture of safety, partly because they are role models and can encourage staff members to act in a way that improves safety; however, these efforts can be weakened by allowing unsafe behaviors to continue. 3 A revised recommendation was added that a just and restorative culture can be encouraged by establishing a clear process for distinguishing between human and system errors.…”

Patient Safety Culture, Infection Prevention, and Patient Safety in the Operating Room: Health Workers’ Perspective

“…13 Surgeons, anesthesiologists, nurses, and other OT personnel play an important role in improving patient safety. 14 The presence of errors, such as unintentional patient exposure in the OR, will have an impact on patient safety. 15 Doctors and nurses who worked longer hours in the OR and reported more mishaps had less positive opinions about patient safety.…”