Peroperative analysis of the surgical procedure

Boer, K. T. den; Dankelman, Jenny; Gouma, Dirk J.; Stassen, H.G.

doi:10.1007/s00464-001-8216-5

Cited by 23 publications

(4 citation statements)

References 25 publications

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“…In addition, components such as a suitable environment, functioning equipment, drugs and disposable items are needed to support the intraoperative process 8. The work process of the surgical team in the OR is mainly described through the surgical procedure and its phases,9 sometimes including the phases of anaesthesia 10. The OR context has considerable potential for interruptions that may interfere with the work of the surgical team 6 11.…”

Section: Introductionmentioning

confidence: 99%

Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study

et al. 2019

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ObjectivesThe work context of the operating room (OR) is considered complex and dynamic with high cognitive demands. A multidimensional view of the complete preoperative and intraoperative work process of the surgical team in the OR has been sparsely described. The aim of this study was to describe the type and frequency of tasks, multitasking, interruptions and their causes during surgical procedures from a multidimensional perspective on the surgical team in the OR.DesignProspective observational study using the Work Observation Method By Activity Timing tool.SettingAn OR department at a county hospital in Sweden.ParticipantsOR nurses (ORNs) (n=10), registered nurse anaesthetists (RNAs) (n=8) and surgeons (n=9).ResultsThe type, frequency and time spent on specific tasks, multitasking and interruptions were measured. From a multidimensional view, the surgical team performed 64 tasks per hour. Communication represented almost half (45.7%) of all observed tasks. Concerning task time, direct care dominated the surgeons’ and ORNs’ intraoperative time, while in RNAs’ work, it was intra-indirect care. In total, 48.2% of time was spent in multitasking and was most often observed in ORNs’ and surgeons’ work during communication. Interruptions occurred 3.0 per hour, and the largest proportion, 26.7%, was related to equipment. Interruptions were most commonly followed by professional communication.ConclusionsThe surgical team constantly dealt with multitasking and interruptions, both with potential impact on workflow and patient safety. Interruptions were commonly followed by professional communication, which may reflect the interactions and constant adaptations in a complex adaptive system. Future research should focus on understanding the complexity within the system, on the design of different work processes and on how teams meet the challenges of a complex adaptive system.Trial registration number2016/264.

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Section: Introductionmentioning

confidence: 99%

Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study

et al. 2019

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“…The procedures were recorded using three cameras and four audio signals using an audiovisual recording system (MPEG Recorder 2.1, Noldus Information Technologies, Wageningen, The Netherlands). More detailed information about the methods used can be found in a previous publication [13]. …”

Section: Methodsmentioning

confidence: 99%

“…The LH surgery was separated into 10 surgical phases and 36 surgical steps based on the method of perioperative analysis of surgeries by Den Boer et al [2, 13], see Table 1 for a description. The phases do not necessarily occur in a chronological order.…”

Section: Methodsmentioning

confidence: 99%

Surgical phase modelling in minimal invasive surgery

et al. 2018

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“…According to the methodology to analyze a peroperative surgical process described by Den Boer et al, all (potential) surgical steps that are commonly undertaken during LH were defined (Table 1) [26, 27]. The recordings were analyzed with The Observer ® XT 11.5 software (Noldus Information Technologies, Wageningen, The Netherlands).…”

Section: Methodsmentioning

confidence: 99%

Surgical flow disturbances in dedicated minimally invasive surgery suites: an observational study to assess its supposed superiority over conventional suites

et al. 2016

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BackgroundMinimally invasive surgery (MIS) is frequently compromised by surgical flow disturbances due to technology- and equipment-related failures. Compared with MIS in a conventional cart-based OR, performing MIS in a dedicated integrated operating room (OR) is supposed to be beneficial to patient safety. The aim of this study was to compare a conventional OR with an integrated OR with regard to the incidence and effect of equipment-related surgical flow disturbances during an advanced laparoscopic gynecological procedure [laparoscopic hysterectomy (LH)].MethodsUsing video recording, 40 LHs performed between November 2010 and April 2012 (20 in a conventional cart-based OR and 20 in an integrated OR) were analyzed by two different observers. Outcome measures were the number, duration and effect (on a seven-point ordinal scale) of the surgical flow disturbances (e.g., malfunctioning, intraoperative repositioning, setup device).ResultsA total of 103 h and 45 min was observed. The interobserver agreement was high (kappa .85, p < .001). Procedure time was not significantly different (NS) [conventional OR vs. integrated OR, minutes ± standard deviation (SD), mean 161 ± 27 vs. 150 ± 34]. A total of 1651 surgical flow disturbances were observed (mean ± SD per procedure 40.8 ± 19.4 vs. 41.8 ± 15.9, NS). The mean number of surgical flow disturbances per procedure with regard to equipment was 6.3 ± 3.7 versus 8.5 ± 4.0, NS. No clinically relevant differences in the mean effect of these disturbances on the surgical flow between the two OR setups were observed.ConclusionsPerforming LH in an integrated OR did not reduce the number of surgical flow disturbances nor the effect of these disturbances. Furthermore, in the integrated OR, repositioning of the monitors was a frequent and time-consuming source of disturbance. In order to maintain the high standard of surgical safety, the entire surgical team has to be aware that by performing surgery in an integrated OR different potential source for disruption arise.

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Peroperative analysis of the surgical procedure

Cited by 23 publications

References 25 publications

Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study

Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study

Surgical phase modelling in minimal invasive surgery

Surgical flow disturbances in dedicated minimally invasive surgery suites: an observational study to assess its supposed superiority over conventional suites

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