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Hierarchical task analysis for identification of interrelationships between ergonomic, external disruption, and
Latif Al-Hakim1,2, Ming Wang3, Jiaquan Xiao3
1Department of Service Science and Operations Management, Zhejiang University, Hangzhou, China. al-hakim@unisa.edu.au.
Surgical Endoscopy
|February 1, 2019
Summary
This study developed a new hierarchical task analysis (HTA) protocol incorporating ergonomics to improve surgical safety. The enhanced HTA significantly reduced disruptive events during laparoscopic radical prostatectomy (LRP).
Area of Science:
- Surgical Safety and Ergonomics
- Minimally Invasive Surgery Techniques
- Human Factors in Medicine
Background:
- Traditional hierarchical task analysis (HTA) in surgery overlooks ergonomic factors that can lead to errors.
- A gap exists in analyzing how ergonomics influences surgical team performance and patient safety.
- This research addresses the need for an HTA protocol that integrates ergonomic considerations.
Purpose of the Study:
- To develop an enhanced hierarchical task analysis (HTA) protocol for surgical procedures.
- To incorporate surgical team actions, disruptions, and ergonomic goals into the HTA framework.
- To evaluate the impact of the developed HTA on safety during laparoscopic radical prostatectomy (LRP).
Main Methods:
- Observations were conducted in Australian and Chinese teaching hospitals during LRP procedures.
- The HTA protocol was expanded to include technical and ergonomic considerations.
- Two groups of LRPs were compared: one adhering to ergonomic goals and one not.
Main Results:
- A significant 43% reduction in external disruptive events was observed.
- Internal disruptive events decreased by approximately 58% when using the enhanced HTA.
- The study involved 29 laparoscopic radical prostatectomy procedures between March 2016 and November 2017.
Conclusions:
- The developed HTA protocol shows potential utility in improving surgical safety.
- The enhanced HTA could serve as a valuable training aid for surgical teams.
- Further evaluation in larger studies is recommended to confirm its effectiveness as a performance checklist.
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