Identifying workflow disruptions in the cardiovascular operating room

Area of Science:

• Medical Human Factors
• Surgical Workflow Analysis
• Operating Room Management

Background:

• Operating room (OR) workflow is critical for patient safety and efficiency.
• Disruptions to surgical flow can negatively impact team performance and outcomes.
• Understanding role-specific challenges is essential for effective OR management.

Purpose of the Study:

• To quantify the frequency and types of flow disruptions experienced by anaesthetists, circulating nurses, and perfusionists in cardiac surgery.
• To identify significant differences in disruption patterns among these key surgical team members.
• To inform the development of targeted interventions for improving OR workflow.

Main Methods:

• Analysis of 15 cardiac surgical cases.
• Data coding using a human factors taxonomy to categorize 878 identified disruptions.
• Statistical comparison of disruption frequencies and resolution times across disciplines.

Main Results:

• Significant differences in disruption frequency were observed between anaesthetists, circulating nurses, and perfusionists.
• Circulating nurses experienced higher rates of coordination disruptions and interruptions.
• Anaesthetists and perfusionists reported more layout-related issues.
• Disruption resolution times varied significantly among the disciplines.

Conclusions:

• A one-size-fits-all approach to managing OR disruptions is inadequate.
• Interventions must be tailored to the specific challenges faced by individual roles within the surgical team.
• Addressing role-specific disruptions can optimize operating room flow and enhance team performance.