Observational clinical human reliability analysis (OCHRA) for competency assessment in laparoscopic colorectal surgery at the specialist level

Abstract

OCHRA is a valid tool for assessing competency at a specialist level in advanced laparoscopic surgery. It has the potential to be used for recertification and revalidation of specialists.

What errors make a laparoscopic cancer surgery unsafe? An ad hoc analysis of competency assessment in the National Training Programme for laparoscopic colorectal surgery in England

“…This work demonstrated the impact of tissue-handling and instrumentusage errors on the assessment of surgical competency. Committing tissue-handling errors has a significant influence on judging competency level, whereas instrumentsrelated errors did not significantly made the assessors consider the performance to be unsafe [4]. The current study corroborated the findings in a larger sample (370 cases vs. 32), through different statistical techniques (Bayesian modelling versus logistic regression) applied to different error classifications.…”

“…[3]. The employed error lists in those tools have been developed from observing surgical procedures with or without using structured framework for categorisation such as observational clinical human reliability analysis (OCHRA) techniques [4]. The weighting of those listed errors in judging surgical competency remains poorly defined, as not all errors have similar impact and consequences.…”

Surgical timing after chemoradiotherapy for rectal cancer, analysis of technique (STARRCAT): results of a feasibility multi-centre randomized controlled trial

“…To evaluate the impact of timing of surgery upon technical performance, operations were video recorded and evaluated using the OCHRA technique [3,6,7]. For laparoscopic surgery, the operation was recorded directly from standard laparoscopic theatre equipment using a Medicapture 300 HD analysis to facilitate evaluation of surgery [8].…”

“…The Objective Clinical Human Reliability Assessment (OCHRA) technique has been successfully applied to evaluate surgical technical performance at the specialist level [3,4]. This technique involves defining errors that could occur within a procedure and then observing an operation to identify errors which are enacted.…”

Identification of technical errors and hazard zones in sleeve gastrectomy using OCHRA

“…In case of any disagreement, the two observers sat together and reviewed the video to reach agreement on the errors. Assessment was done according to the principles of Observational Clinical Human Reliability Assessment (OCHRA) [6][7][8]. A correlation was studied between the occurrence of errors and the duration of surgery and major early postoperative (30-day) complications.…”