Human factors and cardiac surgery: a multicenter study

Area of Science:

• Cardiovascular Surgery
• Surgical Outcomes Research
• Human Factors Engineering

Background:

• Surgical outcomes are influenced by numerous factors, including patient-specific variables and procedural complexities.
• The role of human factors in surgical performance and patient safety remains an area requiring further investigation.

Purpose of the Study:

• To investigate the impact of human factors on surgical outcomes using arterial switch operations as a model.
• To analyze the relationship between human failures and adverse events in a series of complex cardiac surgeries.

Main Methods:

• Collected data included patient-specific variables, procedural details, and observations from a human factors researcher.
• Developed a multivariable model to assess the influence of human factors on outcomes, adjusting for baseline patient variables.
• Analyzed major and minor human failures identified from observational reports.

Main Results:

• Overall mortality was 6.6%, with 24.3% of cases experiencing death or near misses.
• Major human failures were strongly associated with increased risk of death and near misses (P <.001).
• Appropriate human factors interventions significantly reduced the risk of death (P =.003), while minor events also correlated with adverse outcomes.

Conclusions:

• Human factors play a critical role in determining surgical outcomes, particularly in complex procedures like arterial switch operations.
• Effective implementation of human factors defense mechanisms can significantly improve patient safety and reduce adverse surgical events.