Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room

Joseph, Anthony; Khoshkenar, Amin; Taaffe, Kevin; Catchpole, Ken; Machry, Herminia; Bayramzadeh, Sara

doi:10.1136/bmjqs-2018-007957

Cited by 41 publications

(37 citation statements)

References 20 publications

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“…For example, handing instruments with even minimal delay can disturb the smooth process [52]; a similar argument can be made for the precision of movements. Problems in tight cooperation can obstruct goals or interrupt the workflow, may elicit anger and tense behavior, and may lower performance [53]. In this sense, tensions may serve as an indicator of coordination problems [54].…”

Section: Discussionmentioning

confidence: 99%

“Disruptive behavior” in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams

et al. 2019

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BackgroundTense communication and disruptive behaviors during surgery have often been attributed to surgeons’ personality or hierarchies, while situational triggers for tense communication were neglected. Goals of this study were to assess situational triggers of tense communication in the operating room and to assess its impact on collaboration quality within the surgical team.Methods and findingsThe prospective observational study was performed in two university hospitals in Europe. Trained external observers assessed communication in 137 elective abdominal operations led by 30 different main surgeons. Objective observations were related to perceived collaboration quality by all members of the surgical team. A total of 340 tense communication episodes were observed (= 0.57 per hour); mean tensions in surgeries with tensions was 1.21 per hour. Individual surgeons accounted for 24% of the variation in tensions, while situational aspects accounted for 76% of variation. A total of 72% of tensions were triggered by coordination problems; 21.2% by task-related problems and 9.1% by other issues. More tensions were related to lower perceived teamwork quality for all team members except main surgeons. Coordination-triggered tensions significantly lowered teamwork quality for second surgeons, scrub technicians and circulators.ConclusionsAlthough individual surgeons differ in their tense communication, situational aspects during the operation had a much more important influence on the occurrence of tensions, mostly triggered by coordination problems. Because tensions negatively impact team collaboration, surgical teams may profit from improving collaboration, for instance through training, or through reflexivity.

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Section: Discussionmentioning

confidence: 99%

“Disruptive behavior” in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams

et al. 2019

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“…Kondutivitas atau hantaran (119)(120)(121)(122)(123)(124)(125)(126)(127)(141)(142)(143)(144)(145)(146)(147)(148) merupakan pengukuran dasar untuk mempelajari gerakan ion (149)(150)(151)(152) , konduktivitas atau daya hantar listrik adalah kekuatan seberapa kuat larutan dapat menghantarkan listrik (188) . Hantaran merupakan kebalikan dari hambatan listrik (195) .…”

Section: Hantaranunclassified

Analisis Molekular dan Transpor Ion Amonium Clorida

Rhaska¹,

Zainul²

2019

Preprint

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Ammonium Chlorida merupakan seanyawa anorganik dengan rumus kimia NH4Cl, berupa garam Kristal putih yang sangat mudah larut dalam air.Ammonium Chlorida banyak digunakan pada bidang industry. Tujuan dari review ini untuk mengetahui karakteristik molekul dan transpor ion Ammonium Chlorida. Metode yang digunakan untuk mengetahui karakteristik molekul yaitu metode pemodelan komputasi di ChemOffice 15.0, dan untuk mengetahui transpor ion Ammonium Chlorida yaitu dengan parameter konduktivitas, viskositas, mobilitas ion, dan gerakan hanyut.Hasil yang didapat yaitu struktur molekul Ammonium Chlorida pada analisis molekuler 2D, dan bentuk molekul 3D. Ammonium klorida memiliki sifat termokimia dalam fasa solid dengan ΔS,C,ΔHf,ΔG pada tekanan 1 atm pada suhu 25°C yang masing-masing memiliki nilai 94,56 J mol-1 K-1, 84,1 J mol-1 K-1, -314,43 kJmol-1, dan -202,97 kJmol-1. Pada suhu yang 100°C dengan tekanan yang sama 1 atm ΔH reaksi yang didapatkan bernilai positif sehingga reaksi pembentukan NH4Cl bersifat endotermis. Interaksi molekul yang terjadi pada ion NH4Cl dapat diperhatikan melalui beberapa parameter, diantaranya adalah konduktivitas, mobilitas, serta kecepatan hanyut ionnya. Konduktivitas dari NH4Cl dipengaruhi oleh konsentrasi, semakin banyak ion yang ada dalam larutan maka mobilitas ion yang juga berhubungan dengan kecepatan hanyut dalam larutan akan semakin berkurang sehingga nilai konduktivitas akan menurun. Mobilitas ion NH4+ yaitu 3,5×10-8m2s-1V-1, serta kecepatan hanyut NH4Cl sebesar 3,00 V/cm. Berdasrkan metoda komputasi dengan ChemOffice 3D, energy yang dibutuhkan NH4Cl untuk bergerak sebesar 14,87 kcal/mol

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“…The OR design and surgical department layout have an essential impact on the intraoperative processes, and therefore the overall efficiency of the surgical procedures. For example, recent studies showed the correlation between OR and equipment layout and surgical workflow disruptions [4,5].…”

Section: Introductionmentioning

confidence: 99%

Surgical workflow simulation for the design and assessment of operating room setups in orthopedic surgery

Neumann

Angrick

Höhn

et al. 2020

BMC Med Inform Decis Mak

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Background: The design and internal layout of modern operating rooms (OR) are influencing the surgical team's collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods: With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. Results: The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion: The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.

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Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room

Abstract: Room design and layout issues may create barriers to task performance, potentially contributing to the escalation of FDs in the OR.

Cited by 41 publications

References 20 publications

“Disruptive behavior” in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams

“Disruptive behavior” in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams

Analisis Molekular dan Transpor Ion Amonium Clorida

Surgical workflow simulation for the design and assessment of operating room setups in orthopedic surgery

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