The Impact of Human Factors on the Safety of Operating Rooms and everyday Surgical Practice

Abstract

Human Factors Engineering (HFE) principles were initially implemented in safety-related procedures in aviation and other high-risk industries to minimize human error-related risks. The introduction of HFE in healthcare aims not to eliminate the 'human factor,' but rather to enable 'engineering' to redesign clinical settings to become resilient to unanticipated events related to operational and/or safety shortcomings. Given the complexity of the Operating Room (OR) and the sociotechnico-cognitive activities that occur during a surgical operation, HFE needs to consider a wide spectrum of Surgical Flow Disruptions (SFD), such as miscommunications, fatigue, workload, physical layout of the site etc. The increase of fully automated/computer-assisted surgical systems into everyday surgical practice highlights the need for specialized technical skills and a subsequent change in mind-set and intraoperative decision-making. The complexity of the modern OR calls out for incorporation of a culture safety also illustrated by the close interaction of Usability Engineering (UE) and Risk Management (RM) throughout the lifecycle of a medical system and by Regulations currently in force. This article discusses the practical parameters of HFE incorporation into surgical practice and aims to highlight how this holistic redefinition of OR settings promotes patient and medical staff safety through mitigation of error-prone processes.