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Measuring intra-operative interference from distraction and interruption observed in the operating theatre
A N Healey1, N Sevdalis, C A Vincent
1Department of Biosurgery and Technology, Clinical Safety Research, Imperial College, University of London, 10th Floor QEQM, St Mary's Hospital, Praed Street, Paddington, London, W2 1NY, UK. a.healey@ic.ac.uk
Ergonomics
|May 24, 2006
Summary
Operating theatre distractions are frequent, impacting surgical team performance. Developing tools to measure intra-operative interference is crucial for improving surgical safety and efficiency.
Area of Science:
- Surgical Safety and Performance
- Human Factors in Medicine
- Operating Theatre Management
Background:
- Distractions and interruptions are common in operating theatres.
- Quantifying intra-operative interference is essential for understanding its impact on surgical teams.
- Existing methods for measuring these events are limited.
Purpose of the Study:
- To develop and validate an observational tool for recording distractions and interruptions during surgery.
- To quantify the frequency and types of intra-operative interference.
- To assess the reliability of the observational tool and its correlation with other metrics.
Main Methods:
- Development of a structured observational tool with pre-defined categories for events.
- Rating of observed events based on team involvement to measure intra-operative interference.
- Observation of 50 general surgical operations in a single operating theatre.
- Inter-observer reliability testing for event ratings and case assessments.
- Correlation analysis between interference levels and door opening frequency.
Main Results:
- A high frequency of interference events (0.29 events/min) was observed.
- The observational tool demonstrated good inter-observer reliability for individual events (r(s) = 0.65) and cases (r(s) = 0.89).
- Intra-operative interference levels (1.04 events/min) correlated significantly with door opening frequency (r = 0.47, p < 0.001).
- Interference sources included intrinsic factors (equipment, procedure) and extraneous factors (bleepers, phone calls).
Conclusions:
- The developed observational tool is a reliable method for quantifying distractions and interruptions in the operating theatre.
- Intra-operative interference is a significant issue with both internal and external sources.
- Further research is needed to refine interference measures and evaluate their impact on surgical team performance and patient safety.
