Quantifying distraction and interruption in urological surgery

Healey, Andrew; Primus, Christopher; Koutantji, M

doi:10.1136/qshc.2006.019711

Cited by 151 publications

(165 citation statements)

References 32 publications

Supporting

Mentioning

152

Contrasting

Order By: Relevance

“…NOTECHS scores correlated inversely with ‘glitch rate’, whereas OTAS scores inversely correlated with the impact of distractions6 10. NOTSS and the Cannon‐Bowers scale correlated well with each other40 46, 48.…”

Section: Resultsmentioning

confidence: 89%

“…In addition to surgeons' technical proficiency, non‐technical skills have been implicated in clinical outcomes after surgery and operating theatre efficiency. These non‐technical skills include, in addition to teamwork, attitudes towards safety, situational awareness, decision‐making, communication and theatre environment1, 2, 3, 4, 5, 6, 7, 8, 9, 10. This review was designed to focus on teamwork.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

View full text Add to dashboard Cite

BackgroundTeamwork in the operating theatre is becoming increasingly recognized as a major factor in clinical outcomes. Many tools have been developed to measure teamwork. Most fall into two categories: self‐assessment by theatre staff and assessment by observers. A critical and comparative analysis of the validity and reliability of these tools is lacking.MethodsMEDLINE and Embase databases were searched following PRISMA guidelines. Content validity was assessed using measurements of inter‐rater agreement, predictive validity and multisite reliability, and interobserver reliability using statistical measures of inter‐rater agreement and reliability. Quantitative meta‐analysis was deemed unsuitable.ResultsForty‐eight articles were selected for final inclusion; self‐assessment tools were used in 18 and observational tools in 28, and there were two qualitative studies. Self‐assessment of teamwork by profession varied with the profession of the assessor. The most robust self‐assessment tool was the Safety Attitudes Questionnaire (SAQ), although this failed to demonstrate multisite reliability. The most robust observational tool was the Non‐Technical Skills (NOTECHS) system, which demonstrated both test–retest reliability (P > 0·09) and interobserver reliability (Rwg = 0·96).ConclusionSelf‐assessment of teamwork by the theatre team was influenced by professional differences. Observational tools, when used by trained observers, circumvented this.

show abstract

Section: Resultsmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Systematic review of methods for quantifying teamwork in the operating theatre

Marshall

Sykes

et al. 2018

BJS Open

View full text Add to dashboard Cite

show abstract

“…In conjuction with their [2] and other groups' [3,4] previous work, it is becoming increasingly, if unsurprisingly, apparent that operating theatres are noisy, distracting places in which to work. This may have both negative and positive effects [5][6][7]. I would strongly support the authors' contention that not all distractions can be avoided and that prioritisation of actions, coupled with better communication within the team, are part of the solution.…”

mentioning

confidence: 75%

“…The extubation papers they quote [5,6] both refer to an animal study in which pigs were exposed to 21.3 AE 2.4 min of 100% oxygen before extubation [5], which is not analogous to the guideline's recommendation of a carefully titrated oxygen bolus to an expired oxygen concentration > 0.9 immediately before extubation.…”

Section: Pre-oxygenation Before Extubationmentioning

confidence: 99%

Who is distracting whom?

Moppett

2015

Anaesthesia

View full text Add to dashboard Cite

“…Surgical flow disturbances were defined as stimuli (potentially) distracting one or more members of the sterile team (Table 2). To assess the (potential) severity, the effect on the sterile team members caused by each observed surgical flow disturbance was graded according to a seven-point ordinal scale modified by Persoon et al (originally described by Healey et al) (Table 3) [25,28]. This scale ranges from '1' as a potentially distracting stimulus to '7' when the sterile team's work is completely interrupted.…”

Section: Annotation and Statisticsmentioning

confidence: 99%

Surgical Flow Disturbances in Dedicated Minimally Invasive Surgery Suites: An Observational Study to Assess Its Supposed Superiority Over Conventional Suites

Blikkendaal

Driessen

Rodrigues

et al. 2016

Journal of Minimally Invasive Gynecology

View full text Add to dashboard Cite

Background Minimally 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 equipmentrelated surgical flow disturbances during an advanced laparoscopic gynecological procedure [laparoscopic hysterectomy (LH)]. Methods Using 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). Results A 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. Conclusions Performing 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 timeconsuming 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.

show abstract

Quantifying distraction and interruption in urological surgery

Abstract: With further refinement and testing, this method may be useful for distinguishing ordinal levels of work interference in surgery and helpful in raising awareness of its origin for postoperative surgical team debriefing.

Cited by 151 publications

References 32 publications

Systematic review of methods for quantifying teamwork in the operating theatre

Systematic review of methods for quantifying teamwork in the operating theatre

Who is distracting whom?

Surgical Flow Disturbances in Dedicated Minimally Invasive Surgery Suites: An Observational Study to Assess Its Supposed Superiority Over Conventional Suites

Contact Info

Product

Resources

About